Articulation disorders

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dgreen8
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Articulation disorders
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2011-04-06 19:46:18
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Articulation Disorders Test III
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Articulation Disorders Test III
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  1. Antcedent events
    • Stimuli designed to elicit a response.
    • Auditory, visual, Kinesthetic
  2. Stimuli presented following a response.
    Consequent Events
  3. Structured opportunity to produce the target. (Ex. rabbit, ring)
    Discrete trial
  4. stimuli arranged to elicit the behavior.
    (/b/sound... bring toys/objects with the target in their name.)
    Evoked Trial
  5. clinician gives a model.
    (visual cueing etc.)
    modeled trials
  6. occurs when the rate of behvior increases above the baseline rate
    postitive reinforcement
  7. distasteful stimulus is removed contingent upon a desired response
    (desired behavior increases)
    negative reinforcement (not the same as "punishment"
  8. *Increasing Behavior Rate*

    A stimulus that is reinforcing in the absence of learning (can be food, toys, stamps, etc)
    primary reinforcer
  9. *Increasing Behavior Rate*

    A stimulus paired with a primary reinforcer that eventually takes on the properties of the primary reinforcer.
    (ex. verbal praise....nice work
    I heard that nice /s/ sound)
    Secondary reinforcer
  10. *Increasing Behavior Rate*

    based on previous experience.
    Conditioned generalized reinforcers
  11. Informative Feedback

    Be specific... tell them what they did that was so great.
    Verbal
  12. Informative Feedback

    Chart or graph
    Nonverbal
  13. Informative Feedback

    using a variety of reinforcers
    Multiple reinforcement contingencies
  14. Informative Feedback

    computer programs..... used often in a school setting
    Mechanical feedback
  15. *Positive Reinforcement**

    Clearly defind behavior that will be rewarded... the client must know what they must do to get the reward. (how our world works)
    • Token Economy
    • 1. Present reward immediatly following the behavi or
    • 2. Agreement concerning how the tokens can be exchanged for prizes.
    • 3. Reinforcement Menu- indicates how many tokens it takes to buy each prize.
  16. *Positive Reinforcement**

    Indicates how many tokens it takes to buy each prize.
    Reinforcement menu
  17. (most effective) if the client knows a correct response has been given, that will be enough to increase behavior rates.
    Self reinforcement
  18. Principles for Self Reinforcement
    1. Clients can't take the reward until after the behavior is demonstrated.

    2. Client has control over the rewards.

    3. Standards are set before the rewards can be given.
  19. ***Schedules of Reinforcement**

    Reinforce all correct responses
    Continuous
  20. Schedules of Reinforcement


    Some responses are not reinforced
    Intermittent
  21. Number of responses a client must produce.
    Ratio Schedule
  22. Amount of time
    Interval
  23. Schedules of Reinforcement

    Interval: Most often used
    Fixed Ratio and Variable ratio
  24. Schedules of Reinforcement

    (Interval) one response/one reinforcer...always the same
    Fixed Ratio
  25. Schedules of Reinforcement

    (Interval) 3 responses/ one reinforcer
    Variable Ratio
  26. ******Decreasing Behavior Rates***

    Misarticulations... often resistant to extinction due to the nueral pathways that have already been made.
    Inappropriate Communication Behaviors
  27. ******Decreasing Behavior Rates***

    Interrupt the treatment process
    Interfering behaviors
  28. ******Decreasing Behavior Rates***

    May occur not in the ability to perform but in the desire to do so (piano lesson, exercise program)
    Extinction

    make sure that what we are doing is resistant to extinction
  29. ******Decreasing Behavior Rates***

    Defined in terms of response rate, not generally used now
    Punishment
  30. ******Decreasing Behavior Rates***

    Client unable to reach the reward (goal is too unattainable for client or too much effort.
    Ratio-Strain

    Make them attainable/reachable quickly
  31. ******Decreasing Behavior Rates***

    Earn and lose or lose only (used when client has been in treatment awhile and they really can do it but their effort is too low... take away tokens
    Response-Cost
  32. Decreasing Behavior Rate

    Following an undesirable behavior, all activity stops. (ex. no talking for 5 seconds)
    Non-exclusion time out
  33. Corrective Feedback

    3 ways to tell the client what they need to do differently.
    Corrective Feedback

    • Verbal
    • Nonverbal
    • Mechanical
  34. Need to be sure the stimulus is a reinforcer.
    Stimulus Withdrawl
  35. Making adjustment during a session because something isn't working or has client mastered the skill and is ready to move on?
    Leveling
  36. Assess generalizations- happens when we want to take a look at how the production of some things we have not trained is going
    • Probe
    • - do after you've done your tx.
    • - no reinfrocements during probes(similar to baserating)

    (Ex./k/ sound-going well so will do a probe of the /g/sound to see if it has generalized to this sound)
  37. Important
    1. Documentation
    2. Accountability
    3. Effectiveness
  38. Instructional Objectives wording:
    • (Do) Max will produce /s/ in isolation.
    • (Conditions) in respose to visual and a model
    • (Accuracy)- with 70% Accuracy
  39. Needs to be measureable (have a beginning and an end.
    • Instructional Objectives
    • - tends to be stock phrases that are used in making objective statements.
    • - Anytime writing a goal for a client, they need to be able to produce with at least 60-70% accuracy or task needs to be leveled back(may need to work on tongue placement or comparision to other phoneme sounds)
    • - Looking for duplication...if I couldn't be there could someone pick up my treat/lesson plan and know what i had planned to do.
    • Include these types of statements.pg. 465 in text
  40. What you want a client to do before thier dismissal.
    • Terminal Objectives
    • - Ex. (Do) Max will produce /s/
    • (conditions) - In conversaitional speech
    • (Accuracy) - with 90% Accuracy
  41. For a specific period of time (short rage)- semester goals.
    Short Term Objectives

    • Ex. (Do) Max will produce /s/ in all postitions
    • (conditions) - in response to visual cues
    • (Accuracy) With 90% accuracy
  42. For that week's session(s)
    Weekly Objectives

    • Ex. (Do) Max will produce /s/ in isolation
    • (Conditions) in conversational speech
    • (Accuracy) with 90% accuracy
  43. Approach that typically focuses on one or two sounds at a time.
    Traditional Approach
  44. Factors for Traditional Approach
    • - Chronological Age
    • - Frequency of occurrence
    • - Stimulability
    • - Extent to which errors are produced
    • - Severity of error

    • - Least=Distortion
    • - Middle = substitution
    • - Most= Omission
  45. Traditional Approach
    5 stages

    *****A little confused on what the actual stages are I have 2 different answers. I will list both: I think the bottom ones are semi stages within each major stage??
    • 1. Sensory Perceptual training
    • 2. Production Training
    • 3. Stabilization
    • 4. Phrases
    • 5. Sentences

    • 1. Sensory Perceptual training
    • 2. Production training
    • 3. Stabilization
    • 4. Transfer and Carry over
    • 5. maintenance
  46. A client isn't required to produce the sound, this is in what stage in the Traditional Approach?
    Sensory perceptual training
  47. Describe sight, sound feel of phoneme.
    Identification
  48. Does this word contain your sound?
    Isolation
  49. Bombardment, vary loudness and duration: goal is to increase sensitivity.
    Stimulation
  50. Focus on listening, may include error detection and correction.
    Discrimination
  51. ***Traditional Approach****
    Production Training (establishment)
    • 1. Imitation/ Auditory stimulations
    • 2. Use of facilitating Contexts- if these don't work the next prodecures are more direct
    • 3. Phonetic Placement
    • - Articulator placement
    • - Modification of breathstream
    • - Appropriate voicing
    • 4.Motokinesthetic - stresses pattern of movement from one to the other
    • 5. Sound approximation (Shaping)- progressive approximation and sound modification
  52. Stress pattern of movement from one to the other.
    Motokinesthetic
  53. Traditional Approach

    Designed to develop the ability to produce the sound quickly and easily.
    Stabilization

    • Productions are "stabilized" at each level before moving on to the next
    • **Be sure steps are very small**
  54. Words are made up of sound sequences.
    Reconfiguration
  55. Client says and writes the sound: 1 syllable words, multisyllable words, whole words.
    Simultaneous Talking and Writing
  56. Client prolongs the sound, then on a signal from the clinician produced the rest.
    Signaling techniques
  57. The ablility to use the new sound in conversation.
    Carryover
  58. Traditional Approach

    Carry Over Activities

    homemework (usually asking them to do things that they can already do)
    Speech Assignments
  59. Traditional Approach
    Carry Over Activities

    Have someone else check the child's speech.
    Self and peer monitoring
  60. Traditional Approach
    Carry Over Activities

    Brief periods of time when we're monitoring their speech. (practice in other settings)

    Ex. show and tell or somone monitor adult during coffee break.
    Nucleus Situations

    Ex. show and tell or somone monitor adult during coffee break.
  61. Traditonal Approach
    Carry Over Activities

    Aware of their own speech production
    Proprioceptive Awareness
  62. Traditional Approach
    Carry Over Activities

    Use the sound in various types of speaking
    Use the sound in various types of speaking

    This was the 5th Activity listed under carryover activities. Really not a definition, just a statement. So there was no answer.
  63. Traditional Approach
    *Maintenance Stage *
    Retention of a learned skill after the therapy is complete (mastery of skill should be retained)

    - client seen less freq. to start(2x's a week to once a week)

    • - Ready for dismissal
    • *if they slip too far back, bring them back in and work on transfer and carry over**
  64. Three Objectives of Sensory Motor Approach.
    1. Heighten responsiveness to patterns of speech movements.

    2. Reinforce correct production of the error sound.

    3. Facilitate correct production in systematically varied contexts.
  65. Sample articulation in a variety of setting over several days.
    Baseline

    Baseline data describes the current state of the behavior

    Behavior must be measureable, have a difinite beginning and end (this is one of the most important but often most difficult in writing goals.) Jimmy will improve his speech is "No Bueno"!!
  66. Positive Reinforcement
    -Immediately follows a response

    -There are many types of reinforcers

    -Satisfies a need of the organism-need of approval

    -Increases the probability of a response recurring.
  67. Increasing Behavior Rate by
    • Positive Reinforcement
    • Negative reinforcement
  68. Any skill that's taught to a client, patient, or student (anything that you attempt to teach)
    Target Behavior
  69. Target Behavior

    Select behaviors that....
    1. Important to change (age appropriate?, developmentally appropriate ?, will it make a difference in the clients social interaction?)

    2 May be reinforced in other settings

    3. Expand communication skills

    4. Linguistically and culturally appropriate.
  70. ABC stands for?
    • Antecedent
    • Behavior
    • Consequence
  71. Stimuli designed to elicit a response?
    Antecedent Events

    Can be auditory, visual, or Kinesthetic
  72. Stimuli presented following a response?
    Consequent Events
  73. 3 different Baseline Trials?
    • Discrete Trial
    • Evoked Trial
    • Modeled Trial
    • *may use other stimulus methods(visual, cueing,etc)**
  74. A Baseline Trail that has
    strutured opportunity to produce the target (rabbit, ring)
    Discrete Trial
  75. A Baseline Trail that a stimuli is arranged to elicit the behavior (/b/ sound...bring in toys/objects with the target in their name)
    Evoked Trial
  76. A Baseline Trail that the clinician gives a model?
    Modeled Trial
  77. Informative Feedback can be ________, __________, _________, and ________.
    Verbal, nonverbal, multiple reinforcement contingencies, and mechanical feedback.
  78. Conditions for effective Reinforcement include:
    - State of need exists

    - Experimenter controls the presentation of the stimulus

    - Reinforcer is positive only if the behavior increases.

    - Choose reinforcers that will not wear out or have no undesirable side effects.
  79. Remember (in reinforcement) to:
    - Don't assume a consequence is a reinforcer.

    - Present reinforcer immediately after behavior

    - dont use monotonous delivery

    - Be sure the client knows why the reinforcer is being given

    - Eye contact is important

    - Consistency!!
  80. Time out is a period of ________- ______________.
    Non-Reinforcement
  81. As a clinician, ask yourself:
    - Is this activity to difficult?

    -Were my instructions clear?

    - Was the reinforcement appropriate? Did they like it, did it work?

    - Were sessions too structured to meet the client's needs?

    - Did I target the appropriate target behaviors?
  82. Systematic Multiple Phoneme Approach

    1 Phase and
    3 levels they are?
    • Establishment Phase
    • Level A
    • Level B
    • Level C
  83. Systematic Multiple Phoneme Approach

    Produce each consonant sound in response to a grapheme or phonetic symbol.
    • Establishment Phase
    • - sound production sheet (SPS)
  84. Systematic Multiple Phoneme Approach

    Visual stimulus- most difficult level
    • Level A
    • Children under 5 skip
  85. Systematic Multiple Phoneme Approach

    Auditory Visual Stimulus - What Level?
    Level B
  86. Systematic Multiple Phoneme Approach

    Stimulus (maximal cueing)- Easiest level
    • Level C
    • *start at level C and move toward level A
    • Holding procedure
  87. Systematic Multiple Phonemes Approach

    Transfer:
    • 1. May work on 5 or more sounds during a session
    • 2. Syllable-use only if the client fails a word probe.. so usually don't use syllables.
    • 3. At word level, use a variety of words with a variety of vowels- when we work on articulation we train a lot of nouns because we can picture them in our head
    • 4. Phrases or sentences- self monitoring begins
    • 5. Reading or Story passages (WWA)-whole word accuracy
    • 6. Conversation level
  88. Systematic Multiple Phoneme Approach
    Maintenance Level
    90% whole word accuracy in various speaking situations without any external support. May monitor for about 3 months May lose about 5%
  89. Systematic Multiple Phoneme Approach

    Maintenance options
    • Return Visits, Clinician visits class, telephone conversations, reports and others
    • - Value of this approach is the speed of remediation
  90. Paired Stimuli Approach
    • - designed for children with few errors or sound distortions
    • - operant principles- only one sound is trained at a time
    • - uses a key word to train production
    • - 4 keywords (keywords are words in which the client says correctly), 2 initial, and 2 final
    • - Key Word: target occurs only once, target produced correctly 9 of 10 times. (ex. Word List)
    • - training words: 10 initial, 10 final, unless errors occurs in only one position.
    • -Use of a picture board P.419
    • - alternate between a key word and a training word=training string
    • -
  91. Paired Stimuli Approach
    3 different Levels
    • word
    • sentence
    • conversation
  92. Paired Stimuli Approach: Word Level
    • - first train the initial position, then final
    • - Third word (target in initial position), produce both key and training words with a breif pause=response unit
    • - Fourth word(target in final postition), produce both key and training word with a brief pause=response unit
    • -Probe for generalization to conversational speech.
  93. Sentence Level:
    • - Ask a question to elicit the key word and a training word in a sentence.
    • - Reinforcement varies
    • - ask a question to elicit the second and third key words(alternate the key word and the training words)
    • - Ask a question to elicit the first and fourth training words.
  94. Conversation Level:
    • - Asks open ended questions
    • - Stop if the child uses the sound correctly in 4 words or there are errors.
    • - Increase level of the #of productions needed for reinforcement. (maybe start with 7, then 10, 13, 15)
    • - Probe after each level
    • -
  95. A key word and a training word is called a ___________.
    Training String
  96. In the Paired Stimuli Approach, a __________ __________ is a word that the client can produce correctly __ out of __ times?
    Key word, 9 out of 10
  97. Paired Stimuli Approach
    Key Words
    • - Target sound occurs only once(for this example the target sounds is./r/
    • - the child says the sound correctly 9 of 10 times.
    • -2 with the sound in the initial position:(rat, rope)
    • -2 with the sound in the final position:(car, bear)
  98. Paired Stimuli Approach
    Training Words
    • - the target sound is misarticulated 2 of 3 times.
    • - Target sound occurs only once
    • - 10 initial: rake, rot, room, rabbit, rice, read, roll, rocks, rattle, rip
    • - 10 final; ear, four, door, pour, hair, star, deer, snore, chair, jar
  99. The successful pairing of the key word with each of the ten training words is
    Training String
  100. T or F When making goals for clients you should set goals you want them to do, not what you want them to stop doing?
    True
  101. ****Traditional Approach***
    Stablization Stage includes
    • 1. Isolation
    • 2. Nonsense Syllables
    • 3. Word level
    • 4. Phrases
    • 5. Sentences
  102. Traditional Approach
    In the Stabilization Stage
    Isolation:
    • - goal is to develop more consistent correct productions
    • - Characteristics
    • - Where is the tongue, what does it look like in the mirror
    • - prolonging, changing intensity, varying the umber of productions
    • - Variety of speech activities (text p.401-402
  103. Traditional Approach
    Stabilization Stage
    Nonsense Syllables
    • - uses a variety of contexts
    • - Reduces interference from old error
    • - prevocalic CV
    • - postvocalic VC
    • - Intervocalic VCV
    • - Initial CVC
    • - Final CVC
    • *may be used as a basis for consonant clusters later*
  104. Traditional Approach
    Stabilization Stage
    Word Level
    • - moves from single syllable words to multisyllabic words.
    • -If client cannot produce words, even though stabel at syllable level.
    • -Reconfiguration- words are made up of sound sequences
    • - Simultaneous talking and writing- client says and writes the sound; 1 syllable words, multisyllable words, whole words.
    • - Signaling techniques- client prolong the sound, then on a signal clinician produces the rest.
    • - if the sound is correct, but an error appears before the rest of the word
    • preform the mouth- (control of context) Create simple words from complex contexts- especially when working with consonant blends Ex. "st" blend as in best. "nice tie", "gr"-great, "big rat"
  105. Traditional Approach
    Stabilization Stage *PURPOSES* at the Word level
    • -Provide numerous opportunites for practice in a variety of increasingly complex utterances
    • - to stablize correct production at each substage (initial, medial, final)
    • - Develop the ability to self correct(self monitor)
  106. Traditional Approach
    Stabilization Stage
    Phrases
    • - think small
    • - Try "slot fillers" or carrier phrases
  107. Traditional Approach
    Stibilization Stage
    Sentences
    • - Start 1st with structured sentences(what we want to get)
    • - level of complexity must be sequenced and controlled
    • - Phonetic context must be controlled
    • - Ex. p.403
    • - Establishing Productions in sentences
    • -slow motion speech
    • -Shadow or echo speech
    • -Corrective set- some sentences are correct and some are not-client must guess
    • -Role Playing
  108. Traditional Approach
    Stabilization Stage
    Conversation
    Move from structured to unstrucured(conversation)
  109. Traditional Approach
    Tranfer and Carry Over Stage
    Carryover Activites
    • Speech assignment
    • Self and peer monitoring
    • Nucleus Situations-practice in other situ.
    • Proprioceptive awareness
    • Use the sound in various types of speaking
  110. ***Distinctive Feature therapy***
    • - often uses the minimal pair approach, but not necessarily.
    • - choose an approach based on what is best for the client
  111. ***Distinctive Feature therapy***

    Select a Target Sound
    (really only effective for errors of substitution)
    • - (after you've done some kind of analysis)
    • -Look at target phonemes and substitutions
    • - distinctive features representing substitutions - Summary of feature changes and number of affected Phonemes.
    • (you want to look at the dist.features that are involved in the phonemes, such as labial,nonlabial, stops,voice, voiceless etc. and see what features are present in the phoneme you want and the phonemes they are producing, then figure out the difference between the two, then decide what is missing and what phonemes they affect. (this is straight from the tape)
  112. ***Distintive Feature Therapy***
    Target Selection
    • - Identify features that neutralize contrast
    • - Consider the frequency with which features occur
    • - Ex. continuance, Stopping
    • - Preferably on that affects the whole group of sounds
    • - Establish one contrast that will generalize.
  113. ***Distinctive Features***
    Therapy
    • - teach motor acoustic patterns
    • - teach the linguistic importance of each sound pair contrast. - sometimes called a linguistic approach
    • - Words should have an equal # of segments. Ex. CVC, VCV
    • - Equal # of phonemes
    • - contrast may be ina a position, but other segments must be identical.
  114. Destinctive Feature Therapy

    Target Sound Selection: Summaried by the outline of dr. barker
    • 1. Teach motor acoustic patterns
    • 2.Teach the linguistic importance of each sound pair contrast
    • 3.Words should have an equal number of segements
    • 4. Equal number of phonemes
    • 5. Contrast may be in any position but other segments must be identical.
  115. What are the two Approach Steps in Minimal Pair Contrast Therapy?
    • 1. Perceptual Training- "point to the_______"
    • 2. Production- the child is required to produce the minimal pairs
  116. Any two phonetically equivalent words that differ only by a single sound property?
    minimal pair

    Broader defn- word pairs that differ by one phoneme
  117. ***Minimal Word Pair Therapy***
    Discussion of the words
    • - The child must have the concept that is being labeled: use words from the childs' lexicon.
    • Discussion of the words
    • - There must be a need to make the word different.
    • - Ask a question that requires a pointing response.
  118. ***Minimal Word Pair Therapy***

    Receptive Training (discrimination testing and training)
    Perceptual Training
    • - clinican says the two words in random order, and the child identifies which word was said
    • -possible modifications- if the child can not get 7 consecutive correct responses, try a diffeent pair or other discrimination tasks.
    • - Poor auditory memory-
    • - try saying the word then delay showing the picture-
    • at this point, the feature is perceived, discriminated, retained.
  119. ***Minimal Word Pair Therapy***
    Production Training
    • Demonstrate use and control of the feature and control of the feature.
    • - child becomes the teacher
    • - work at word level
    • - reinforce correct articulation
    • - think in terms of features, not sounds.
  120. ***Minimal Word Pair Therapy***
    Carry Over
    • Move to phase, keeping both words-negative practice
    • - make the 2 word utterance as natural as possible
    • - Reinforce the feature in the target word
    • - three word carries phrases, "touch the _______. sometimes called slot filler.
    • - Begin home practice

  121. Phonological Process Therapy

    Summary per Dr. Barker outline
    • A. Goals- to eliminate instablility, eliminate homonyms, and establish contrasts.
    • B. Natural Processes
    • 1. Final consonant deletion
    • 2. Velar Fronting
    • 3. Stopping
    • 4. palatal fronting
    • 5. Liquid simplification
    • 6. Assimilation
    • 7. Cluster Reduction
    • 8. unstressted syllable deletion
  122. Phonological Process Therapy

    Potential Targets
    • 1. Early developing
    • 2. Posterior/anterior
    • 3. /s/ clusters
    • 4. Liquids
  123. Phonological Process Therapy

    Inappropriate targets
    • 1. Voiced final obstruents
    • 2 Final "ng"
    • 3. Post vocalic syllabic [l]
    • 4. Weak syllable deletion
    • 5. Voiced and voiceless "th" phonemes
  124. ****Phonological Process Therapy****
    Target Selection
    • - Frequency of occurrence
    • - Effect on intelligibility
    • - Chronological Age: age appropriate
    • - See p. 280
    • The goal is to eliminate instability, eliminate homonyms and establish contrasts.
  125. ****Phonological Process Therapy****
    Natural Processes
    • - final consonant Deletion
    • - Velar fronting; t for K
    • - Stopping: t for S
    • - Palatal fronting: S instead of Sh
    • - Liquid simplification: W for R or L
    • - Assimilation: puts a sound that already occurs in the words somewhere else.
    • - Cluster reduction
    • - Unstressd syllable deletion
  126. Sensory Motor Approach
    Assumptions:
    • -Syllable is the basic unit of training
    • - Use of facilitating contexts)some phonetic contexts that allow for a sound to occur)
  127. Sensory Motor Approach
    Characteristics
    • -No auditory discrimination training
    • - training begins at the syllable level
  128. Sensory Motor Approach
    Goals and Approach
    Goal- increase auditory, tactile and proprioceptive awareness of the motor patterns of speech.

    Approach- find a phonetic context with accurate prodution of the target sound (McDonald Deep)
  129. Minimal Word Pair Therapy

    Summary per Dr. Barker outline
    • 1. Discussion of the words
    • 2. Receptive training (perception training) descrimination testing and training)
    • 3. Production training: demonstrate use and control of the feature
    • 4. Carry over
  130. 3 objectives in the Sensory Motor Approach.
    • 1. Heighten responsiveness to patterns of speech movements
    • 2. Reinforce correct production of the error sound
    • 3. Facilitate correct production in systematically varied contexts
  131. Minimal Pair Contrast Therapy

    Goal and Approach Steps:
    - goal- To establish contrasts

    • - perceptual training
    • - Production: the child is required to produce the minimal pairs.
  132. MAXIMAL OPPOSITIONS APPROACH (MAXIMAL CONTRAST)

    Choose sounds that are different in 3 ways:
    • 1. manner
    • 2. Place
    • 3. voice
    • - Maximal oppostions really are differences in distinctive features
    • - Most generalization occurs when focusing on sounds that client consistently produces in error, then move to inconsistent errors.
    • - Use when there are at least 6 error sounds (moderate to severe)
  133. Maximal Oppositions Approach
    -target selection
    • - Select 2 sounds not in the childs inventory
    • - Select class features (see p.80)
    • - Don't train driscrimination
  134. Maximal Oppositions Approach
    2 Phases
    • 1. Imitation
    • 2. Spontaneous
  135. Maximal Oppositions Approach
    Imitation Phase
    Picture cards are presented and the client reaches 75% accuracy in 2 sessions.
  136. Maximal Oppositions Approach

    Spontaneous Phrase
    Produce word pairs without the clinician model(no model)- continue to 90% accuracy in 3-12 sessions
  137. Muliple Oppositions Therapy (Multiple Contrast)

    Goal:
    - treat a large number of contrasts
  138. Multiple Oppositions Therapy

    Benefits:
    • - Shortened length of time to improve intelligbility
    • - Useful for a child who substitutes one sound for multiple phonemes (Ex. h/t, h/k, h/d,h/g.)
    • - Uses minimal pairs for the entire set of errors.(going to do all of the errors)
    • - Efficient intervention

    *multiple and Maximal kinda overlap a little bit, Multiple uses some of the principles of maximal contrast.
  139. Multiple Oppositions Therapy

    Procedures and/or Approach Steps
    • *use Maximal contrasts to select targets*
    • - Use imitation until the client reaches 70% in 2 sessions
    • - Use spontaneous until the client reases 90% in 2 sessions
    • - Spontaneous contrast and generalization in untrained words until it reaches 90% accuracy
    • - Conversation with natural intervention (mostly monitoring vs. TX)
  140. Other Considerations:

    Phonemic Disorders with Language Disorders
    • - Language and phonology may be related (differing opinions)
    • - Children with phono. disorders also have language disorders
    • - Intervention needs to target both.
  141. Other Considerations

    Remediation/Morphemes
    • - word pairs that show the constrastive morphemes(plurals, past tense)
    • - use clusters when possible ("cats"
    • - Sentence level- build structures needed: copula "he is mad...." "he is sad...." (targeting both articulation and language at the same time)

    - Conversation Level: subjective and objective pronouns (he/she vs. him/her)
  142. Other considerations:

    Emerging Phonological System
    • - Inventory speech sound they produce and in what position.
    • - Syllable Shapes that they produce.
    • Goal is to expand vocabulary that is also intelligible (intelligible core vocab)
    • Especially function words that express needs and wants.
  143. Other Considerations

    Multiple Vowel Error
    • Not very common but is challenging to train because you can't see them.
    • - vowel inventory
    • - Accuracy of productions
    • - Error pattern
    • - use one known and one unknown vowel in minimal pairs (difficult in comparision to /i/.
  144. Other Considerations

    Oral Motor Exercises
    • - do not include speech attempts
    • - controversial: no speech production, used with children with no evidence of neuromotor disorders.
    • - Would time be better spent in training articulation
    • - No evidence the exerices help improve speech production.

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