Analysis and Interpretation

Determining Whether or not there is a phonological problem Nature of the problem, if one If treatment is merited Plan for treatment

Assess. Constructs From Different Perspectives. (Williams, 2002) Traditional - Stimulability Select sounds that are stimulable. Rationale: sounds that are stimulable are easier to learn. Phonological – Stimulability Select sounds that are not stimulable. Rationale: (1) Stimulable sounds will emerge without direct intervention; (2) Non-stimulable sounds represent less phonological knowledge than stimulable sounds. Selecting sounds that represent less phonological knowledge results in greater change across the sound system

Assess. Constructs From Different Perspectives. (Williams, 2002) Traditional – Consistency Select sound(s) that are inconsistent. Rationale: Variability may be important indicator of flexibility, change, and potential growth. Phonological – Consistency Select sound(s) that are consistent in their error productions. Rationale: Consistent errors reflect category representations, which will result in appropriate category shift to correspond to the target representation as a result of treatment.

Severity Degree of a client’s articulation and phonological disorder

Intelligibility Understandibility of spontaneous speech Perceptual judgment by listener Factors influencing intelligibility Number errors Types of errors Consistency of errors Frequency of occurrence errors Phonological processes used A simple tally of number of sounds in error is not an adequate index of intelligibility. Low correlation between percentage of consonants correct and intelligibility.

Intelligibility – Other factors Listeners’ familiarity with speech pattern Prosodic factors Rate Inflection Stress Pauses Voice quality Loudness Fluency Linguistic experience of listener Social environment of communication act Message content Communication cues Transmission media

Intelligibility – Quantifying No standard procedure Approaches – Gordon-Brannan (1994) Open-set word identification Closed-set word identification Open-set word identification calculates percentage of words understood in a sample where the examiner transcribes a speech sample and determines the percentage of words indentifiable Ope-set word identification – calculates the percentage of words understood in a sample where the exmainer transcribes a speech sample Closed-set word identification a listener identifies words read from a prescribed word lists Rating scale procedures – most have not been validated 1. interval scale (continuum 5-9 points) 2. Direct magnitude scale – judgment is made relative to standard stimulus

Rating scale procedures - Clinical Judgment Scales You can rate severity and intelligibility Based on judgment of one or more clinicians familiar with the client Interval scale (Table 10.1 and 2) Direct magnitude scale

Intelligibility – selection The poorer the ratings the more likely for intervention Most valid may be to calculate the actual percentage of words understood in a speech sample

Severity Percentage of Consonants Correct (PCC) Shriberg and Kwiatkowski (1982) Index to quantify severity of involvement In page 273

PCC See your book for the actual rules and formula

Severity – PCC Process Examiner makes judgments of individual sounds in continuous speech tape recorded (50-100 utterances) Only intended target consonants (selected examples below) No consonant added before vowels No schwars No repetitions of syllables No consonants in words completely or partially unintelligible No third repetition of words In page 273

Severity – PCC Process Scoring Scored as incorrect Deletions of target consonant Substitutions Partial voicing of initial target consonants Distortions Additions Initial /h/ deletion and final n/ng substitutions in stressed syllables

Severity – PCC Process Watch out for Calculation Dialectal variations Fast or casual speech Allophones scored as correct Calculation Fast speech Dunno for don’t know Allophones flap in water

Issues with intelligibility ratings There is low correlation with between intelligibility and number of consonants pronounced correctly.

Stimulability Diagnostic therapy might give a better indication General guide for identification of clients who may correct their phonological errors without intervention False positives and false negatives Research research low stimulability scores made significantly more improvement that those with high stimulability sores when they received tx without tx, ch with high stimulability scores demonstrated significant improvement, others studies did not prove this

Error Patterns Place-Manner-Voicing Work on characteristic to address several items or just work on particular items, be careful because it is not necessarily generalized Distinctive feature – absence or presence of particular distinctive features Based on acoustic, perceptual and articulatory characteristics Articulatory characteristics are most useful Criticism that may not be useful because it is a binary system and does not address all the possible productions

Error Patterns Phonological process analysis Looks at influence of sound position within word and syllable shapes Multiple pattern occurrence Unusual pattern occurrence (idiosyncratic processes) Sound preferences

Developmental Appropriateness Debate about cognitive abilities

Comparing Performance to Ages Norms Consider error in relation to age Norms are statistical averages Should not be used for predictive purposes Normative data used as a guide to counsel parents Normative data conceal successes and errors in attempts to produce given phoneme, and that these are frequent patterns of development High individual variability a.      Comparing Performance to Age Norms          i.      Error of phoneme is considered in relation to the age of the child          ii.      Norms are statistical averages            iii.      Should not be used for predictive purposes            iv.      Normative data is used as a guide to counsel parents.             v.      Normative data conceal that development consists of a mixture of successes and errors in successive attempts to produce a given phoneme, with gradual increases in the percentage of successes and decreases in the relative number of errors, and that coexistence of success and error is the most frequent pattern of developing use of the sounds of speech           vi.      High individual variability

Selecting behaviors to Target Stimulability start at the most complex linguistic unit the client can imitate selection of the most or least stimulable???? Work on exemplars at the same time Frequency of occurrence The most frequent the problem the more severe the intelligibility Frequency of usage in the language

Selecting behaviors to Target Developmental Appropriateness Contextual analysis Look at what surrounds the sound to identify where the sound is produced appropriately Where are the sounds produced?? These sounds take less time to correct Contextual – look and see where the

Selecting behaviors to Target Phonological process analysis Focus on developing appropriate patterns instead of eliminating pattern and those that are stimulable Phonological knowledge analysis Tests child’s cognitive awareness of a particular sound at a linguistic level. Most knowledgeable and least knowledgeable gauged as consistency of usage. Target the least knowledge. Dialectal considerations Social-vocational expectations Phonological knowledge analysis – page 293

Treatment

Attacking Treatment Goals Vertically structured treatment program One or two goals are trained to some performance criterion before proceeding to another target (traditional) Mass practice on a restricted on a restricted number of training items will facilitate generalization to other non-trained items. Horizontally structured treatment program (training broad) Several targets at the same time Client is learning commonalities or relationships among target sound productions and treatment will be more efficient.

Attacking Treatment Goals Cyclically structured treatment program Focus of targets in cyclical schedules (2-4 days per week or 2-4 weeks per cycle) Regardless of progress the next cycle focuses on a second set of processes. Treatment proceeds regardless of progress. It reflects how children actually learn sounds

Scheduling Intermittent scheduling – twice a week over an extended period Block scheduling – daily sessions for a shorter temporal span separated by time between the blocks. May be Better unless those with organic impairments. Under eight no more than half an hour.

Group versus Individual No difference Classroom based Group versus individual a.      No difference b.      Classroom based

Intervention style Drill * Drill play * Structured play Play * more effective               Intervention style – a and b more effective a.      Drill b.      Drill play c.      Structured play d.      Play e.      E.