additional direct speech sound production interventions from stimulability to cas
TRANSCRIPT
Additional Direct Speech Sound Production Interventions
From Stimulability to CAS
Four Non-Contrastive Direct Approaches
• Core Vocabulary
• Cycles Approach
• Nuffield Centre Dyspraxia Programme (NCDP)
• Stimulability
Core Vocabulary Approach (Dodd et al)
Developmental level Targeted stage of production
Targeted outcomes
Emerging
Developin
g
Elaborat
Key components Tech and/or materials
Specific diagnoses
Plannin
Prograing
Execution
Speech Production
Speech Perception
Phon awareness
Other oral Language
Literacy
X X *Consistent production of > 50 functionally powerful words *Sound-by-sound and syllable-by-syllable dense response drill with pictures
Picture stimuli
*Incon-sistent speech *CAS
X X X
CV: Review Case Study
• Describe the characteristics of child
• How was her speech assessed?
• Describe intervention and results
CV: Review Questions
Cycles Approach (Hodson)
Developmental level Targeted stage of production
Targeted outcomes
Emerging
Develo
Elabor
Key components
Tech and/or materials
Specific diagnoses
Planning
Programmi
Execution
Speech Production
Speech Perception
Phono awareness
Other oral Language
Literacy
X *Ordering of phonological patterns within cycles, auditory bombardment, facilitating contexts, active involvement, and self-monitoring*Home program
*Amplification device*5x8 index cards*Motivational/experiential play items
X X Xa Xa
Unique features of the Cycles approach
1. Identify Broad Phonological DEVIATION Patterns
2. Target Each Deficient PRIMARY Phonological PATTERN (e.g., /s/ clusters) 2-4 Hours (average) per CYCLE*
3. Incorporate AMPLIFICATION & METAPHONOLOGICAL Tasks During EACH Session
4. Reassess between Cycles & RECYCLE Primary PATTERNS as needed until Emerge in Conversation
5. Increase COMPLEXITY Gradually
6. Target SECONDARY PATTERNS after Specified Criteria are met (Hodson, 2007)**
• FOCUSED AUDITORY INPUT/Stimulation for Toddlers• “MULTISYLLABICITY” & Complex Consonant Sequences for older students
who have intelligibility issues*Cycle is a period of time (Varies from 5 to 15 hours. Depends on number of PATTERNS that need to be targeted. Sessions are 60 minutes per
week; Children typically require 3-4 Cycles.)
**Hodson, B. (2007). Evaluating and Enhancing Children’s Phonological Systems: Research and Theory to Practice. Wichita, KS: PhonoComp Publishing.
Cycles: Review Case Study
• Describe the characteristics of child
• How was his speech assessed?
• Describe intervention and results
Cycles: Review Questions
Nuffield Centre Dyspraxia Programme (P. Williams & Stephens)
Developmental level Targeted stage of production
Targeted outcomes
Emerging
Developi
Elaborat
Key components Tech and/or materials
Specific diagnoses
Plannin
Progra
Executio
Speech Production
Speech Perception
Phono awareness
Other oral Language
Literacy
X *Build speech processing skills from bottom up through est motor programs for single sounds in isolation & increasing phonotactic complexity*Auditory discrim and specific NSOM skills within repetitive practice
NDP3 manual + pix materials and worksheets
CAS X X X X X
Unique features of the Nuffield Centre Dyspraxia Programme
• Created in UK for children with SSD/CAS, 3-7 years• A motor and linguistic approach• Build accurate motor programs for phonemes, words and
sentences, supported by picture cues• Establish through repetitive practice• Develop a contrastive system at each phonotactic level (eg
C, V, CV, CVCV, CVC) • Work on several targets simultaneously across speech
system• Photocopiable pictures/worksheets
NCDP: Case Study
• Describe the characteristics of child
• How was his speech assessed?
• Describe intervention and results
Stimulability Intervention (Miccio)
Developmental level Targeted stage of production
Targeted outcomes
Emerging
Developi
Elab Key components
Tech and/or materials
Specific diagnoses
Plann
Programmin
Execu
Sp Prod
Sp Perc
Phon awareness
Other oral Language
Literacy
X *Stim + nonstim sds targeted*Sounds paired with alliterative characters and body motions
Alliterative sound character card illustrations (http:// www. Brookes publishing.com/williams/miccio.htm
Very young children with limited sound inventory
X X X
Unique features ofStimulability intervention
• For young children with limited phonetic inventories who are not stimulable for many or all absent sounds
• Major components– Target stimulable and non-stimulable sounds– Speech sounds are associated with
alliterative characters– Speech sounds are associated with hand/body
movements– Vocal practice encouraged through play-based turn-taking activities– Early success and successful communicative attempts ensured with
practice on both stimulable and non-stimulable sounds
Stimulability: Case Study
• Describe the characteristics of child
• How was his speech assessed?
• Describe intervention and results
Stimulability: Review Questions
Levels of Evidence (LOE)
Level Description Approach
1a Well-designed meta-analysis of >1 randomized controlled trial
None
1b Well-designed randomized controlled study CV; Cycles; Stim
2a Well-designed controlled study without randomization
Complexity; Cycles
2b Well-designed quasi-experimental study CV; Stim
3 Well-designed nonexperimental studies, i.e., correlational and case studies
CV; Cycles; NCDP; Stim
4 Expert committee report, consensus conference, clinical experience of respected authorities
Cycles