Traditional Motor Approach (Van Riper & Emerick (1984)
1. Which population benefits from this approach?
- Individuals with specific speech sound disorders, articulation
Traditional Motor Approach (Van Riper & Emerick (1984) 2. Why do we use this method?
- Therapy for speech form, production of speech sounds
Traditional Motor Approach (Van Riper & Emerick (1984) 3. What are the steps
Step 1: Sensory perceptual training/ear training (if needed)
* Child discriminates between the target sound and other sounds, including irregular production (does not produce the sounds, just discriminates)
Step 2: Production isolation
* Goal is to elicit standard production of the target sound alone (not in combination)
* Ways to get a norm production – auditory stimulation/imitation, phonetic placement method & sound modification method/shaping
Step 3: Use of facilitating context
* Child can say the target sound in specific contexts; we can use these contexts to elicit the target sound
Step 4: Production of nonsense syllables
Typical sequencing:
* Target sound + vowel (CV)
* Vowel + target sound (VC)
* Vowel + target sound + vowel (VCV)
Step 5: Production words
* Goal is to maintain the target production in the context of words
* Organize words from eat to more difficult to produce (easy words, fewer syllables, open syllables, stressed syllable, singleton)
Step 6: Production structured contexts (phrases & sentences)
* Maintain the production accuracy of the target sound by placing the words into short phrases and sentences
Step 1: do not include the target in the phrase
Step 2: include the target in the phrase; prepare objects/pictures that DO NOT have the target sound
Step 3: include the target in the phrase; prepare objects/pictures that DO have the target sound
Step 7: Production of spontaneous speech
Carryover: the target production is seen in conversational speech in various settings (in therapy, outside of therapy, at home, monitoring the child)
Minimal Opposition Contrast Approach
1. Which population benefits from this approach?
- Children with mild to moderate phonological disorder (Baker 2010, 2016) & Williams (2000b)
Minimal Opposition Contrast Approach2. Why do we use this method?
- Use of pairs that differ in only one phoneme
Minimal Opposition Contrast Approach 3. What are the steps in target selection?
Step 1: Identify the phonological process that occurs most often in the child’s speech
Step 2: Select the phonological process that mostly affect intelligibility
Step 3: Think about the child’s age in respect to when the phonological process should have been suppressed
* After you have selected the phonological process … choose the target word pairs keep in mind:
* First word has the sound that is NOT in the child’s inventory
* Second word has the sound the child CAN produce
Minimal Opposition Contrast Approach4. What are the steps in a therapy session
Step 1: Discussion of Words (pig/fig)
* What is it? (animal/fruit)
Step 2: Discrimination Testing and Training
* The clinician repeats the two words at random and the child must point to the picture
* The child must point to the correct image 7 times to ensure they can differentiate between each sound
Step 3: Production Training
* The client is instructed to ‘be the teacher’ and the therapist points to the word produced. If the child is unable to produce the target sounds distinctively, traditional approach cues can be used here
Step 4: Carryover Training
Multiple Oppositions Approach
1. Which population benefits from this approach?
- Children with at least six phones missing from their inventory
- Children with a consistent phonological disorder (Dodd, 2013)
- According to Dodd’s classification, this would be those with a moderate to severe consistent phonological disorder
Multiple Oppositions Approach2. Why do we use this method?
- Alternative approach to minimal opposition approach
- Used when there is a collapse of phonemic contrast
Multiple Oppositions Approach3. What are the steps in target selection?
Step 1: Identify the presence of a collapse of phonetic contrast
Step 2: Select two to four treatment targets based on the collapse
* Choose targets that are maximally different in place, manner, and/or voicing
Step 3: Find minimal pairs that incorporate these sounds in the initial position
* Make sure you have multiple examples for each target
Multiple Oppositions Approach4. What are the steps in therapy session?
Phase 1: Familiarization & Initial Production of Contrasts
Step 1: Show the child how each sound differs from the others
Step 2: Make sure that the child understands the concept that each picture depicts
Step 3: You label each picture and the child imitates
Phase 2: Production of Contrast & Interactive Play
Step 1: Child produces each word after the clinician’s model
Step 2: The child labels the images. If they make an error the clinician points to the wrong image to bring this to the child’s attention
Step 3: The child engages in a play activity with the pictured contrast
Phase 3: Contrasts Within Communicative Contexts
* The child produces the target spontaneously while engaged in structured play
* Assess using generalization probes
Phase 4: Conversational Recasts
* If the child produces the sound with 90% during structured activities but not in spontaneous speech, the clinician repeats the child’s utterance in the correct manner
The Cycles Approach
1. Which population benefits from this approach?
- Designed for children with severe to profound phonological impairments
- Extensive omissions, substitutions, very restrictive consonant repertoire
- Using cycles approach, unintelligible children can make progress in short time (Tyler et al., 1987).
The Cycles approach 2. Why do we use this method?
Begins with primary patterns, moves to secondary and advanced patterns
* The targeted patterns in the cycle are used to stimulate the emergence of a specific sound or pattern, not the mastery of it
The Cycles approach 3. What are the steps in target selection?
“Primary Target Patterns” – Cycle 1
- Lack of Syllableness
* Phonological Process: weak syllable deletion - Singleton consonants when consistently omitted in one word position
* Phonological Processes: Initial consonant deletion & final consonant deletion - Anterior/Posterior Contrasts (k/g)
* Phonological Process: fronting
* If a child is not stimulable, try the articulatory approach first - /s/ in singleton and clusters (word initial or final position)
* Phonological Process: stopping of /t/ for /s/ - introduce cluster /st/
* Phonological Process: consonant cluster reduction of /s/ cluster - Liquids and liquid clusters in all word positions
* Phonological Process: gliding
“Secondary Target Patterns” – Cycle 2
- Palatals
* glide /j/
* /∫, ʒ, ʧ, ʤ/
* vocalic /ɝ, ɚ/
* word-medial /ɹ/.
* singleton stridents, /f/, /s/ if not present - Word medial and word final /s/ and stops
- Consonant clusters with sonorants
* glide clusters /kw/
* liquid cluster /sl/ - Voicing contrasts (prevocalic only)
- Other consonant clusters such as /skw/ or /str/
- Residual context-related processes (Hodson, 2011)
Typical Session- cycles
- Review the prior week’s production task
* The child reviews the preceding session’s word cards - Auditory bombardment
* The clinician provides 20 words that contain the target pattern for this session - Target word cards
* The clinician draws, colors or pastes pictures of 3-5 target words on large index cards while repeating the words modeled by the clinician - Production practice through experiential play
* Clinician and child take turns naming pictures
* Clinician provides models and/or cues
* Clinician also gives opportunity to use target words in conversation - Stimulability probing
* Clinician assesses the child’s stimulability for the next session’s potential targets
* Most stimulable speech sounds are then targeted for the next session - Auditory bombardment (step 2 is repeated)
- Home program
* Parent or school aid repeats step 2 and the child labels pictures
Maximal Oppositions Approach
1. Which population benefits from this approach?
- Children with at least six phones missing from their inventory
- Dodd’s classification, children with consistent phonological disorder
Maximal Oppositions Approach . Why do we use this method?
- Target selection method NOT a therapy approach
- Choses sounds that are very different based on the number of distinct features that differentiate the two phonemes (distinctive feature theory)
- It’s thought that when maximal opposition is acquired, minimal ones may be easier
Maximal Oppositions Approach3. What are the steps?
Selecting Targets (Singletons)
Step 1: See if any of the sounds on the vertical axis are missing from the inventory
Step 2: See if any of the sounds on the horizontal axis are missing from the inventory
Step 3: Compare the number of distinctive features, looking for the highest number
Complexity Approach
1. Which population benefits from this approach?
- Children with moderate to severe phonological impairments (consistent phonological disorder (Dodd)).
- Not a good approach for children with mild SSD
Complexity Approach2. Why do we use this method?
- Target selection method NOT a therapy approach
- The assumption is that if we target more difficult sounds, the untreated easier sounds will also improve
Complexity Approach3. What are the steps?
Selecting Targets (Singletons)
- Error patterns: sounds not in the child’s inventory
- Stimulability: sounds that are NOT stimulable
- Implication Universals: imply that if the child has acquired more difficult structures, the easier structures are implied
- Developmental Norms: later developing sounds have priority over earlier developing sounds
Complexity Approach selecting Targets (Clusters)
What sounds to choose:
* Clusters that are NOT in the child’s inventory
* Can select a cluster in which one sound is in their inventory
* Preferably, both sounds are missing and not stimulable
Clusters with the smallest sonority different between the consonants within a cluster keep in mind:
* Some clusters do not follow sonority rules (the first sound is more sonorant than the second)
* S-clusters are not good starts using this approach
