My client, M. was recently diagnosed with learning disability and he has language and articulation problems. He is 6 years old and has been in speech therapy since 2005.
Previous clinicians mostly worked on M.’s articulation errors. He has problems with /l/ in all positions of words. I’ve been working on his /l/ in initial and medial positions of words during this semester using, the fishing game or picture cards.
I have been mostly focusing on M’s language this semester. We have been working on sentence- story comprehension, finding the main idea of the passage, and talking about a specific topic, to improve his language skills. We also work on following the directions, sequencing and the use of basic concepts. I read him a different book every session, and use picture cards for finding the main idea and talking about a topic. It’s sometimes hard for him to concentrate and comprehend the sentences, so, I always try to direct his attention toward the activity and trying to improve his listening skills. I also ask him questions about the stories or passages, to pressure him to listen and find the right answer and also explain if he can’t find the right answer and have him repeat it to help him comprehend the subject. For following sequential directions with basic concepts, we use worksheets and sometimes oriental directions for him to carry the information through his daily life. I basically give him sequential directions and make him do exactly what I said. Research support the widely use of following the sequential directions, asking questions and explaining facts about topics.
I believe M is improving in some ways. My supervisor supports the techniques and the activities I use with him and she believes we have a good interaction. M loves all kinds of activities and he’s such a great client to work with.
Bunce, B. Referential Communication Skills: Guidelines for Therapy. Language, Speech, and Hearing Services in Schools, 22, 296-301.
Sunday, April 13, 2008
Thursday, February 28, 2008
Spring '08 Blog 1
My client, K, is 4 years old. She has been diagnosed with delayed speech and language and she has articulation problems. She has been receiving therapy since Fall ‘07.
K is having problems with /s/, /l/, /t/, and she’s deleting final consonants and reducing initial clusters. She is substituting “him- her” with “he- she”. She also talks very rapidly. For her talking rate I modal slow speech and sometimes I just tell her to slow down without making that very obvious.
The previous clinician worked on some of K’s articulation errors by giving her maximal cues and worked on her pronouns by action cards with many verbal cues. I’m using minimal pairs for her deleting of final consonants, reducing clusters and final /l/ sounds in word level. Using minimal pairs is working pretty well when she concentrates and understands the difference between two different words. I’m trying to keep her on task with different activities and games during minimal pairs since minimal pairs can get really boring for an active 4 year old kid. However, she’s a very bright child who immediately comprehends the difference between right and wrong. So, many times she self-corrects herself. The use of minimal pairs is widely used with children who have many articulation errors. It helps distinguish between target- non-target sounds and it creates more generalization.
Also, I’m focusing on her pronoun confusion a lot, too. I’ve been only using picture cards that show what boys or girls doing. I, firstly, want her to get the idea of correct usage of “he” and “she” in basic concepts before I can move on with carry-over activities. And she is starting to get the idea of the correct use since again she’s self-correcting herself many times! And I’m mostly cueing her about her incorrect productions. Cueing is being used in many areas in speech language pathology. It is very helpful to children if it’s explanatory and if it shows logic. It helps children learn and comprehend the subject. My supervisor also supports these methods and encourages me and the client as she sees the improvement.
K likes almost every activity we do during therapy. She attends well, and works on activities. She prefers visually attractive activities with lots of color and funny pictures.
It’s only been 4 therapy sessions since I’ve been working with K, although both me and my supervisor think, she is improving. She is becoming more aware of what we’re trying to show her and the correct use of speech and language. The methods we’re working on are helping K to develop a more fluent speech and language.
References:
Kouri, Theresa A., Selle, Carrie A., Riley Sarah A. (2006). Comparison of Meaning And Graphophonemic Feedback Strategies for Guided Reading Instruction of Children with Language Delays. American Journal of Speech- Language Pathology, 15, 236-256.
Geirut, Judith A. (2001). Complexity in Phonological Treatment: Clinical Factors. Language, Speech And Hearing Services in Schools, 32, 229- 241.
K is having problems with /s/, /l/, /t/, and she’s deleting final consonants and reducing initial clusters. She is substituting “him- her” with “he- she”. She also talks very rapidly. For her talking rate I modal slow speech and sometimes I just tell her to slow down without making that very obvious.
The previous clinician worked on some of K’s articulation errors by giving her maximal cues and worked on her pronouns by action cards with many verbal cues. I’m using minimal pairs for her deleting of final consonants, reducing clusters and final /l/ sounds in word level. Using minimal pairs is working pretty well when she concentrates and understands the difference between two different words. I’m trying to keep her on task with different activities and games during minimal pairs since minimal pairs can get really boring for an active 4 year old kid. However, she’s a very bright child who immediately comprehends the difference between right and wrong. So, many times she self-corrects herself. The use of minimal pairs is widely used with children who have many articulation errors. It helps distinguish between target- non-target sounds and it creates more generalization.
Also, I’m focusing on her pronoun confusion a lot, too. I’ve been only using picture cards that show what boys or girls doing. I, firstly, want her to get the idea of correct usage of “he” and “she” in basic concepts before I can move on with carry-over activities. And she is starting to get the idea of the correct use since again she’s self-correcting herself many times! And I’m mostly cueing her about her incorrect productions. Cueing is being used in many areas in speech language pathology. It is very helpful to children if it’s explanatory and if it shows logic. It helps children learn and comprehend the subject. My supervisor also supports these methods and encourages me and the client as she sees the improvement.
K likes almost every activity we do during therapy. She attends well, and works on activities. She prefers visually attractive activities with lots of color and funny pictures.
It’s only been 4 therapy sessions since I’ve been working with K, although both me and my supervisor think, she is improving. She is becoming more aware of what we’re trying to show her and the correct use of speech and language. The methods we’re working on are helping K to develop a more fluent speech and language.
References:
Kouri, Theresa A., Selle, Carrie A., Riley Sarah A. (2006). Comparison of Meaning And Graphophonemic Feedback Strategies for Guided Reading Instruction of Children with Language Delays. American Journal of Speech- Language Pathology, 15, 236-256.
Geirut, Judith A. (2001). Complexity in Phonological Treatment: Clinical Factors. Language, Speech And Hearing Services in Schools, 32, 229- 241.
Sunday, November 25, 2007
Clinic Blog 2
I have still been working with A, a 7 year old boy this semester. . A was diagnosed with some articulation problems and has been having therapy in WVU Speech Clinic since spring 2007.
What I have been doing lately with A, for him to earn the correct productions of /r/, /sh/ and /th/ in all positions of words, is still more or less the same technique I was using before; the traditional motor approach with using phonetic placement techniques. I've been using phonetic placement especially with /r/ sound. When we first started to work on his /r/ sound, he quickly picked up the phonetic placement clues and he was able to produce /r/ sound in isolation.
I used the phonetic placement techniques to teach him the /r/ sound because he was stimulable enough and old enough to understand the placements of his tongue. And with the help of a lot of visual and oral cues he was able to produce /r/ correctly. And I thought it would be a good idea for him to be aware of where to place his tongue when he produced the sound. I used the techniques from the book Articulatory and Phonological Impairments. Also, researches show that using placement techniques and visual and oral cues are effective and appropriate in articulation errors in children. My supervisor also supported and thought these techniques were reasonable and would be effective to use.
We have been also working on his /th/ and /sh/ sounds in sentence level lately by reading sentences and producing the sounds correctly in sentence level.
A has been showing some improvement so far with his disarticulations with /r/ sound. He also has been showing a well improvement with his /th/ and /sh/ sounds. He started to concentrate more and it helped him do his work harder.
References:
Shuster, L., Ruscello, D., Smith, K. (1992) Evoking /r/ Using Visual Feedback. AJSLP, 1, 29-34.
Bauman-Waengler, J. (2004). Articulatory and Phonological Impairments: A Clinical Focus. Boston:Pearson.
What I have been doing lately with A, for him to earn the correct productions of /r/, /sh/ and /th/ in all positions of words, is still more or less the same technique I was using before; the traditional motor approach with using phonetic placement techniques. I've been using phonetic placement especially with /r/ sound. When we first started to work on his /r/ sound, he quickly picked up the phonetic placement clues and he was able to produce /r/ sound in isolation.
I used the phonetic placement techniques to teach him the /r/ sound because he was stimulable enough and old enough to understand the placements of his tongue. And with the help of a lot of visual and oral cues he was able to produce /r/ correctly. And I thought it would be a good idea for him to be aware of where to place his tongue when he produced the sound. I used the techniques from the book Articulatory and Phonological Impairments. Also, researches show that using placement techniques and visual and oral cues are effective and appropriate in articulation errors in children. My supervisor also supported and thought these techniques were reasonable and would be effective to use.
We have been also working on his /th/ and /sh/ sounds in sentence level lately by reading sentences and producing the sounds correctly in sentence level.
A has been showing some improvement so far with his disarticulations with /r/ sound. He also has been showing a well improvement with his /th/ and /sh/ sounds. He started to concentrate more and it helped him do his work harder.
References:
Shuster, L., Ruscello, D., Smith, K. (1992) Evoking /r/ Using Visual Feedback. AJSLP, 1, 29-34.
Bauman-Waengler, J. (2004). Articulatory and Phonological Impairments: A Clinical Focus. Boston:Pearson.
Friday, October 19, 2007
Clinical Blogging 1
My client is a 7 year old male. A has been diagnosed with some articulation problems and receiving articulation therapy since spring 2007 in WVU Speech Clinic.
As the past treatment, the previous clinician had worked on the sounds that are in error by using the traditional motor approach. Since A is intelligible and stimulable, I am also using the same therapy approach- the traditional motor approach to stabilize correct productions of A’s sounds that are in error. I’m also giving oral, visual and tactile cues during the therapy sessions.
Some researches show that many clinicians use traditional motor approach and it is effective with many clients.
My supervisor also recommended that the traditional approach could be efficient in order to improve A’s sounds that were in error.
In the client’s case, A has been having some difficulties focusing on the topic. He likes interesting games-materials to use during an activity to really concentrate, so I provide different kinds of materials for A to focus on the activities.
I can see that A is learning and trying to improve his errors with accurate reinforcements. I believe this therapy approach is working because his sounds that are in error are getting better and we are moving forward precisely on our goals through sessions with A.
References:
Kamhi, A.G. (2006). Treatment Decisions for Children with Speech-Sound Disorders. Language, Speech, and Hearing Services in Schools, 37, 271-279.
Gierut, A.J. (1998). Treatment Efficacy: Functional Phonological Disorders in Children. Journal of Speech, Language, and Hearing Research, 41, 85-100.
As the past treatment, the previous clinician had worked on the sounds that are in error by using the traditional motor approach. Since A is intelligible and stimulable, I am also using the same therapy approach- the traditional motor approach to stabilize correct productions of A’s sounds that are in error. I’m also giving oral, visual and tactile cues during the therapy sessions.
Some researches show that many clinicians use traditional motor approach and it is effective with many clients.
My supervisor also recommended that the traditional approach could be efficient in order to improve A’s sounds that were in error.
In the client’s case, A has been having some difficulties focusing on the topic. He likes interesting games-materials to use during an activity to really concentrate, so I provide different kinds of materials for A to focus on the activities.
I can see that A is learning and trying to improve his errors with accurate reinforcements. I believe this therapy approach is working because his sounds that are in error are getting better and we are moving forward precisely on our goals through sessions with A.
References:
Kamhi, A.G. (2006). Treatment Decisions for Children with Speech-Sound Disorders. Language, Speech, and Hearing Services in Schools, 37, 271-279.
Gierut, A.J. (1998). Treatment Efficacy: Functional Phonological Disorders in Children. Journal of Speech, Language, and Hearing Research, 41, 85-100.
Friday, August 17, 2007
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