Client Initial: C. Client’s Age: 3
Client’s Diagnosis: Fluency
Number of years client has been in tx: this is her first semester
Summary of past tx: no past tx
Description of the Technique used:
My client is a 3 year old female, C. Her diagnosis is fluency; however, she exhibits many articulation errors as well, but it is not recommended she work on the two problems simultaneously, so we are focusing on fluency first. She exhibits mostly repetitions in conversation. She has just been admitted into therapy this semester. So, these are her first few weeks of treatment. Upon the recommendation of my supervisor and an expert in the area of fluency that resides in our department here at WVU, I am using the Shine Systematic Fluency Training System. This program has four activities that are arranged on a hierarchy of least to most difficult. They are picture identification, story book activities, picture matching activity, and surprise box activity. The client is only three years old, so her preferences are considered in that the program was modified for her in the beginning to use the slow, easy speech (“new voice”) only during the card activities at first so she could get used to it. When the new voice was used throughout the whole session, she became overwhelmed and was uncooperative. So, we are slowly integrating it into the other activities as she gets used to it so she doesn’t automatically dismiss the treatment. My supervisor and I felt the therapy would be more beneficial to her that way. She is learning unexpected bits and pieces in addition to targeted slow and easy speech for fluency. For example, in the picture card identification sessions, she did not know some of the pictures, but when she was told she began to learn the word/picture associations and use them the following sessions. As far as research literature goes, the Shine System an article on the ASHA website suggests use of this system for children between the ages of 3 and 9 years old. This article also lists the four activities within the Shine System that C. is using. C. is progressing well at this time.
Reference:
Lang Speech Hearing Services in Schools. Ramig and Bennett 26 (2): 138.
Monday, November 26, 2007
Wednesday, October 17, 2007
Blog 1 about Mr. I. =)
Client Initial: I. Client’s Age: 5
Client’s Diagnosis: Articulation errors
Number of years client has been in tx: 1 year 11 mo.
Summary of past tx: cleft palate surgery in 2005 followed by follow up at cleft palate clinic and articulation therapy in WVU speech clinic after that
Description of the Technique used: I. is currently working on four phonemes in the initial position of words in therapy. In addition, he is to work on /k/ in isolation. When I began therapy this year, he produced the /k/ sound to almost sound like /j/. He couldn’t seem to produce /k/ at all even when cued visually and auditorily. So, in order to allow the client to feel exactly where the /k/ is produced my supervisor suggested I try to elicit the /k/ sound by instructing him to make a static sound. I told him to make the sound that the radio makes when the station goes out. I then showed him visually and auditorily how to make this static sound. I opened my mouth and made the sound while he looked in at tongue placement. He understood and tried it. In the next couple sessions he began to shy away from /j/ for /k/ and start to make more of an approximation of /k/. This was some progress, but not quite the /k/ in isolation, just the approximation. The few sessions that have followed those initial ‘static practice’ sessions have improved. He has actually made the /k/ during the static but still is unable to make the sound in isolation. The goal is to have I. consistently produce /k/ in isolation and I definitely see progress being made toward reaching this goal after modeling the static sound as a placement cue!
Evidence: I. is only five years old so I would say this technique would fall under preferences for him. It allows him to feel in his mouth where and how the sound is produced and he seems to prefer to make this sound to try to elicit /k/ productions rather than just trying over and over with failure to correctly produce /k/. With the model and placement cue, I. is able to feel and practice the /k/ sound for himself. I am hoping he is soon able to make the /k/ in isolation without the aid of the static sound. But, until then, at least he is making approximations that are closer and closer to /k/ as the sessions progress!
Evidence: Although my supervisor has had success in the school system with this technique; she said she doubts there are any articles specifically on using the “static sound”; however, I found a helpful manual that she has used as well. According to the Building Good Speech guide, when it comes to the /k/ sound sometimes the auditory visual method is not enough to get the child to produce the sound correctly. So, there must be further assistance. The suggestion on p. 140 that includes having the client open their mouth wide and produce the sound /k^/ to assist in the elevation of the back of the tongue is sort of drawn out a little further in the method I am using with the “static sound”. Kathleen Pendergast uses this method as one of seven suggestions to aid in correcting the /k/ sound. Also, in the article Speech-Language Pathology in School Settings, some examples of cues that can be used to elicit sounds like /th, f, and r/ are given, which isn’t the same cue as /k/; but is still along the same premise. This article emphasizes the importance of the speech language pathologist to developing children. The development of good sound production aides in communication skills which can, in turn, essentially make or break a child’s self esteem and likelihood to thrive.
References:
Pendergast, K. (1986). Building Better Speech: K.
Speech-Language Pathology in School Settings. (2007, September 21). In Wikipedia, The Free Encyclopedia. Retrieved 22:29, October 17, 2007, from http://en.wikipedia.org/w/index.php?title=Speech-Language_Pathology_in_School_Settings&oldid=159471490; http://sumsearch.uthscsa.edu/cgi-bin/SUMSearch.exe?SearchString=speech+cues&TEXTBOOK=&language1=&AGE=all&SUBJECTS=HUMAN&LANGUAGE=ENGLISH&Proxy=no&news=no#Wikipedia
Client’s Diagnosis: Articulation errors
Number of years client has been in tx: 1 year 11 mo.
Summary of past tx: cleft palate surgery in 2005 followed by follow up at cleft palate clinic and articulation therapy in WVU speech clinic after that
Description of the Technique used: I. is currently working on four phonemes in the initial position of words in therapy. In addition, he is to work on /k/ in isolation. When I began therapy this year, he produced the /k/ sound to almost sound like /j/. He couldn’t seem to produce /k/ at all even when cued visually and auditorily. So, in order to allow the client to feel exactly where the /k/ is produced my supervisor suggested I try to elicit the /k/ sound by instructing him to make a static sound. I told him to make the sound that the radio makes when the station goes out. I then showed him visually and auditorily how to make this static sound. I opened my mouth and made the sound while he looked in at tongue placement. He understood and tried it. In the next couple sessions he began to shy away from /j/ for /k/ and start to make more of an approximation of /k/. This was some progress, but not quite the /k/ in isolation, just the approximation. The few sessions that have followed those initial ‘static practice’ sessions have improved. He has actually made the /k/ during the static but still is unable to make the sound in isolation. The goal is to have I. consistently produce /k/ in isolation and I definitely see progress being made toward reaching this goal after modeling the static sound as a placement cue!
Evidence: I. is only five years old so I would say this technique would fall under preferences for him. It allows him to feel in his mouth where and how the sound is produced and he seems to prefer to make this sound to try to elicit /k/ productions rather than just trying over and over with failure to correctly produce /k/. With the model and placement cue, I. is able to feel and practice the /k/ sound for himself. I am hoping he is soon able to make the /k/ in isolation without the aid of the static sound. But, until then, at least he is making approximations that are closer and closer to /k/ as the sessions progress!
Evidence: Although my supervisor has had success in the school system with this technique; she said she doubts there are any articles specifically on using the “static sound”; however, I found a helpful manual that she has used as well. According to the Building Good Speech guide, when it comes to the /k/ sound sometimes the auditory visual method is not enough to get the child to produce the sound correctly. So, there must be further assistance. The suggestion on p. 140 that includes having the client open their mouth wide and produce the sound /k^/ to assist in the elevation of the back of the tongue is sort of drawn out a little further in the method I am using with the “static sound”. Kathleen Pendergast uses this method as one of seven suggestions to aid in correcting the /k/ sound. Also, in the article Speech-Language Pathology in School Settings, some examples of cues that can be used to elicit sounds like /th, f, and r/ are given, which isn’t the same cue as /k/; but is still along the same premise. This article emphasizes the importance of the speech language pathologist to developing children. The development of good sound production aides in communication skills which can, in turn, essentially make or break a child’s self esteem and likelihood to thrive.
References:
Pendergast, K. (1986). Building Better Speech: K.
Speech-Language Pathology in School Settings. (2007, September 21). In Wikipedia, The Free Encyclopedia. Retrieved 22:29, October 17, 2007, from http://en.wikipedia.org/w/index.php?title=Speech-Language_Pathology_in_School_Settings&oldid=159471490; http://sumsearch.uthscsa.edu/cgi-bin/SUMSearch.exe?SearchString=speech+cues&TEXTBOOK=&language1=&AGE=all&SUBJECTS=HUMAN&LANGUAGE=ENGLISH&Proxy=no&news=no#Wikipedia
Friday, August 17, 2007
Orientation Day
My name is Ashley and I am a graduate student at WVU in the field of speech pathology. Classes begin Monday; and that is when the clinic schedule will be posted as well. I am excited and nervous to begin therapy! I am interested in both rehab and pediatric areas at this point, however, that may change with experience. I am eager to get started and comments on my future blogs are welcome.
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