CDO 338 14

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shanamd2011
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187770
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CDO 338 14
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2012-12-07 09:55:03
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Treatment Phonological Disorders
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Treatment of Phonological Disorders
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  1. Phonological Approaches
    • These approaches are for clients who are unintelligible and have multiple misarticulated sounds.
    • Phonological awareness is an umbrella term. Phoneme awareness is specifically looking at being able to recognize specific sounds.
  2. Phonologically Based Approaches
    Objectives:
    • 1. Suppression of processes through intervention
    • of sounds affected by the process
    • 2. Awareness of patterns that we use in our language
  3. Phonologically Based Approaches
    A goal basic to all phonological intervention is facilitating the reorganization of a child’s phonological system and enhancing the strategies for processing phonological information.
  4. Phonologically Based Approaches
    • Cycles approach
    •    Hodson & Paden, 1991
    • Phonological Awareness Approaches
    •    Gillon, 2000
    • Major Contrast Approaches
    •   A. Lynn Williams, 2000
  5. Cycles Approach
    • Designed for intervention of highly unintelligible children
    • —Focus on facilitating emergence of phonological patterns, contrasted with meeting a criterion for mastery of individual phonemes
    • —A phoneme that represents a deficient pattern becomes the target
    • Kids with phono impairment we work really hard with them with suppressing phonological processes and when they are mostly intelligible we then have to clean up their articulations.
    • NEVER forget about input.
    • Use a phonological approach for highly unintelligible individuals.
  6. Cycles Approach
    • 1.Stimulation/Auditory Bombardment
    •    In every session you must do this 
    • 2.Production Training/Semantic Awareness Contrasts
    •    Teach the child the target (10 minutes)
    • 3.Practice core words in target process
    •    Using games you practice the target sound.
    • 4.Probe
    •    Get the stuff for next week and see how the child does with it.
    • 5.Auditory Bombardment
    •    Have child listen to the sound again.

    • This is called cycles because you don’t wait until they have mastered anything. You just continually move to the next thing. Be systematic and keep moving because
    • you are reorganizing the system not training on individual sounds.
    • 3 full cycles for a highly unintelligible preschooler.
    • An hour of therapy is recommended per session.
  7. If he does a full cycle. Then you test him and see what processes he still has. If he has suppressed a process then you skip that in the next cycle.
  8. Cycles Approach
    • —A cycle is a period of time during which all phonological patterns needing treatment are facilitated in succession. 
    • —Major phonological deviations present in at least 40% of the possible occurrences are to be targeted.
    • Each phonological pattern is targeted in for app 60 minutes per context before going on the next pattern. 
    • —One pattern is targeted per session.
    • —The length of a cycle varies from 5 to 16 weeks
    • —Three or four cycles are usually required for an unintelligible child to become intelligible.
  9. Phonological Awareness Approaches
    • Children with expressive phonological impairments (especially severe) have been shown to be at greater risk for later literacy problems 
    • (Hodson & Strattman, 2004).
    • —There is a relationship between expressive phono abilities & phono
    • awareness.
    • —What are Phonological Awareness Skills?
    • —Awareness of the sound structure of a language and the ability to manipulate sounds in words
    • They need more input.
  10. Phonological Awareness Skills
    • —Rhyming:do these words sound alike: cat-hat?
    • Phoneme isolation: tell me if /b/ is in the beginning or at the end of the word “ball”?
    • —Phoneme manipulation: Say the word “man” without the /m/ sound. 
    • —Sound blending:  What does tea---------cher say?
    • —Sound segmentation: What are the 3 sounds in the word dog?

    • You might choose a phonological awareness (input) first and then focus on output.
    • Good kindergarten teachers are working on rhyming every day and giving students lots of auditory input.
  11. Major Contrast Approaches
    • Minimal Pairs
    • Multiple Oppositions
    • Maximal Oppositions
  12. Minimal Pairs
    • —AKA – Contrast Therapy
    • —Oldest—used since the 80s
    • Most widely used
    • —Contrasts child’s error with target sound
    • —Eliminates common phonological processes
    • —Fronting, Stopping, Gliding, Cluster reduction, & Final consonant deletion
    • Useful with Mild to moderate errors
    • —The task of treatment is to eliminate inappropriate rules or processes.
    • —You change their system by using their meaning.
    • —Change their inappropriate rules in their language center.
    • Used for children that have one really bad phonological process. It can be mixed with cycles training.
  13. Minimal Pairs Approach
    • Compare and contrast two words.
    •   Example: 
    • bow/bone, me/meet –final consonant del.
    • cake/take, game/dame- velar fronting
    • soon/spoon, feet/fleet- cluster reduction
  14. Minimal Pairs Approach
    Treatment session:
    • Establish the meaning of words-teach meaning with pictures
    • Receptive testing and training-point to pictures that you hear
    • Production training-produces the word and clinician points
    • Carryover activities- words in phrases and conversations
  15. Multiple Oppositions Approach
    • Williams (2000)
    • —This is also considered contrastive therapy.
    • —The difference between multiple oppositions and minimal pairs involves the number of contrasts to be trained. Minimal pairs train a single contrast, multiple oppositions train several oppositions across an entire rule set.

    • Child says “tip” for “sip", "kip”,
    • “chip”, and “trip”.  They are using stopping, fronting, deaffrication, and cluster reduction. You use all these words to train affect learning across an entire rule set. 
    • —The goal is to place additional demands on memory, attention and increase semantic load
  16. Maximal Contrasts
    • Maximal oppositions by Gierut (1989;1990)
    • —The difference between this approach and minimal pairs is the comparison sound that will contrasted with the target sound. The comparison sound is not the child’s errored
    • sound.  It must be a sound that produced correctly by the child and the comparison sound must be maximally distinct from the target sound.
    • “me” and “she”
    • “my” and “shy”
    •  Minimal pairs is part of a contrasts approach. From that we derived multiple oppositions approach.
    • The idea is that we work on targets that are beyond what the child should be able to do in hopes that the stuff in between will fall into place. – We often use this when we have run out of options.
    • If it isn’t working after 16 months then we need to change it up.
  17. Phonologically Based Approaches
    Metaphon (metalinguistic) Approach
    Developed to facilitate cognitive reorganization of children’s speech sound systems.
  18. Phonologically Based Approaches
    Metaphon (metalinguistic) Approach Premise:
    • children can change their sound productions through developing an awareness of the similarities and differences in duration, placement and manner of production for speech sounds.
    •    —Demonstrated through classification sorting
    •    —2 phases
  19. Metaphon
    Phases:
    • Phase 1:Properties of Sound
    • Phonological production concepts &
    • terminology are enhanced through classification (sorting) of non speech sounds noisy/whispered;  front/back
    • Phase 2:Sound Production
    • Clients become aware of communication
    • breakdown which are facilitated by applying their
    • knowledge of the phonological system.
  20. Metaphon continued:
    • Children learn to monitor themselves in sentence production & modify what they say for more effective communication.
    • Assists cognitive-linguistic reorganization.  Results of a study of Scottish preschoolers demonstrated that children using this approach improved expressive phonological productions.
  21. Matching the Approach to the Child
    • “…,virtually everything works (including maturation). The critical concern pertains to the overall expenditure of time, along with potential impact of disordered phonologies on academic achievement.”
    •   -B. Hodson (1992)
    • THE GOAL IS EFFECTIVE AND EFFICIENT TREATMENT
  22. Conclusions
    • There are many different approaches to phonological intervention.
    • —No single approach is correct for all children.
    • —We must choose the right approach based on the child’s individual profile. 

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