MOTORBASED APPROACHES TO INTERVENTION I INTRODUCTION Intervention for
• MOTOR-BASED APPROACHES TO INTERVENTION
I. INTRODUCTION** • Intervention for speech sound disorders is very exciting • There is nothing in the world like the feeling you get when a child first says a sound correctly!!
Non-Speech Oral-Motor Exercises** • Your book authors do not believe that oral motor exercises are beneficial for anybody • They say research has not proven that oral motor exercises help • Roseberry’s position: these exercises are very helpful for children with oral motor problems
• **Kent, R. D. (2015 November ). Nonspeech oral motor movements and disorders: A narrative review. American Journal of Speech. Language Pathology. • He said that NSOMMs can be part of practice in orofacial myology • Can be used with persons with dysarthria and dysphagia • Don’t just reject NSOMMs wholesale
II. TRADITIONAL APPROACH (Van Riper)** • Around since 1920 s • Still popular and widely-used today • Motor-based approaches stem from Van Riper’s traditional approach
Perceptual (ear) training…** • Most SLPs today don’t emphasize it, but I think it can’t hurt to do a little bit of this • Ear training is useful when the child is tired of producing the sound but you need to still keep working and maximizing therapy time
Ear/Perceptual Training:
Perceptual Training continued:
A. Production Training: Sound Establishment
Successive approximation:
B. Production Training: Sound Stabilization** • Stage 6 Conversation • ↑ • Stage 5 Sentences • ↑ • Stage 4 Phrases • ↑ • Stage 3 Words • ↑ • Stage 2 Nonsense syllables • ↑ • Stage 1 Isolation
• 1. Isolation—use variety of fun activities** • 2. Nonsense syllables —I don’t really use these • 3. Words —begin with words that are meaningful to the child. I work on sounds: • 1. word-initial • 2. word-final • 3. word-medial • 4. Clusters
For example, with /s/: ** • Begin with soup, see, sun (word-initial) • Next: bus, face, piece (word-final) • Then: Classes, lesson (word-medial) • Last: Crust, stop, faster (clusters)
• **4. Phrases – in-between stage—carrier phrases common—e. g. : • I see ____ • This is___ • 5. Sentences – various length and complexity (examples bottom of p. 405)
• 6. Conversation** • Start with structured conv. —e. g. , SLP gives a topic or specific pictures to talk about • Transition to natural conv. —open ended. E. g. , “Tell me what costume you wore for Halloween. ’
C. Transfer and Carryover** • Vary the audience and settings • Speech assignments • In small groups—what are some practical strategies for implementing these ideas in a school setting?
D. Maintenance
III. CONTEXT UTILIZATION APPROACHES** (not emphasized on test) • Assume that speech sounds are not produced in isolation but rather in syllable-based contexts • Assume that certain phonetic contexts can facilitate correct sound usage • Assumes you can find a context where the error sound is produced correctly
For example, a child has a th/s substitution…** • But you find that she can produce /s/ correctly in watch-sun • You have her say watch-sun with various stress patterns, and then move to sequences such as watch-sea, watch-sat, etc.
In sum, contextually-based approaches assume: • The ch can make the sound correctly in some context • Extensive motor practice of articulatory behaviors at the syllable level works to correct the sound
IV. CONCURRENT APPROACH** • Said SLPs don’t have to use hierarchy • First establish sound in isolation and CV, VC combos— 80% accuracy • Then, mix it up in tx!
CSHA Dr. Steve Skelton
For example, in one session: ** • 1. /r/ in final position of words • 2. /r/ in VC combos • 3. /r/ in sentences in word-initial position • 4. /r/ in word-medial position in phrases
Dr. Skelton: ACTIVITIES AND IDEAS FOR ELICITING AT LEAST 150 PRODUCTIONS PER GROUP SESSION
• Post charts individual/group competition** • Create stations--students do something different every minute or so while practicing sounds • E. g. , one ch on whiteboard, one putting puzzle together, one lying on floor, one using flashcards at table
• E. g. , “Say /r/ 10 times by itself while you are doing jumping jacks. ”** • “Say at least 3 sentences with /s/ while you draw a picture on the whiteboard. ” • “Say ‘the’ while you are doing hopscotch”
• Echo microphone** • Puppets, costumes • Roll a dice or draw a number from an envelope to determine how many productions they have to make
OTHER IDEAS FOR CENTERS** • Read books or stories with target sound • Hula hoops • Jump rope
• Blocks • Put Bingo chips into jar • Pick up sticks • Blow bubbles
True-False • You are working with Candace, a 5 -year old, in a group of 4 children. All have th/s substitutions. You are having Candace subvocalize during the other children’s turns, meaning that she is silently writing down the words that the other children are saying.
V. CORE VOCABULARY APPROACH (a fave )** (uses both motor and linguistic principles) A. Introduction Designed for the 10% of children with functional SSDs characterized by inconsistent errors on the same words These children don’t have childhood apraxia of speech Been used with 2 -year olds, bilingual children, Down Syndrome
B. Structure of Intervention
For example: ** • If the child needs to use the bathroom, it’s hard if he says this differently every time • So the goal might be for him to say “potty” • If he can’t, we can teach him to say /a-i/ every single time he needs to go • Much easier on him and his caregivers!
I love it!!
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