1. Additional Direct Speech Sound Production Interventions
From Stimulability to CAS

2. Four Non-Contrastive Direct Approaches
Core Vocabulary
Cycles Approach
Nuffield Centre Dyspraxia Programme (NCDP)
Stimulability

3. Core Vocabulary Approach (Dodd et al)
Developmental level
Targeted stage of production
Targeted outcomes
Emerging
Developing
Elaborat
Key components
Tech and/or materials
Specific diagnoses
Plannin
Prograing
Execution
Speech Production
Speech Perception
Phon awareness
Other oral Language
Literacy X
*Consistent production of > 50 functionally powerful words
*Sound-by- sound and syllable-by- syllable dense response drill with pictures
Picture stimuli
*Incon-sistent speech
*CAS
Stabilizing the child's language then fine tune.
Needs to have 40% inconsistancy to be considered inconsistant.

4. CV: Review Case Study
Describe the characteristics of child
How was her speech assessed?
Describe intervention and results

5. CV: Review Questions planning… Page 118 table 5.1
Severe and inconsistant. Goals-using 50 powerful words identified by parents and teacher twice weekly for 30 minutes. First session work on 10 of the 50 to 70 words. Establish best possible production. Production is drilled sound by sound and then practiced in games. Service delivery includes therapist, parents and teacher.
Untreated probe words every 14 days.
Once consistant you can switch to a contrastive apporach.

6. Cycles Approach (Hodson)
Developmental level
Targeted stage of production
Targeted outcomes
Emerging
Develo
Elabor
Key components
Tech and/or materials
Specific diagnoses
Planning
Programmi
Execution
Speech Production
Speech Perception
Phono awareness
Other oral Language
Literacy X
*Ordering of phonological patterns within cycles, auditory bombardment, facilitating contexts, active involvement, and self-monitoring
*Home program
*Amplification device
*5x8 index cards
*Motivational/experiential play items Xa

7. Unique features of the Cycles approach
Identify Broad Phonological DEVIATION Patterns
Target Each Deficient PRIMARY Phonological PATTERN (e.g., /s/ clusters) 2-4 Hours (average) per CYCLE*
Incorporate AMPLIFICATION & METAPHONOLOGICAL Tasks During EACH Session
Reassess between Cycles & RECYCLE Primary PATTERNS as needed until Emerge in Conversation
Increase COMPLEXITY Gradually
Target SECONDARY PATTERNS after Specified Criteria are met (Hodson, 2007)**
FOCUSED AUDITORY INPUT/Stimulation for Toddlers
“MULTISYLLABICITY” & Complex Consonant Sequences for older students who have intelligibility issues
*Cycle is a period of time (Varies from 5 to 15 hours. Depends on number of PATTERNS that need to be targeted. Sessions are 60 minutes per week; Children typically require 3-4 Cycles.)
**Hodson, B. (2007). Evaluating and Enhancing Children’s Phonological Systems: Research and Theory to Practice. Wichita, KS: PhonoComp Publishing.

8. Cycles: Review Case Study
Describe the characteristics of child
How was his speech assessed?
Describe intervention and results

9. Cycles: Review Questions

10. Nuffield Centre Dyspraxia Programme (P. Williams & Stephens)
Developmental level
Targeted stage of production
Targeted outcomes
Emerging
Developi
Elaborat
Key components
Tech and/or materials
Specific diagnoses
Plannin
Progra
Executio
Speech Production
Speech Perception
Phono awareness
Other oral Language
Literacy X
*Build speech processing skills from bottom up through est motor programs for single sounds in isolation & increasing phonotactic complexity
*Auditory discrim and specific NSOM skills within repetitive practice
NDP3 manual + pix materials and worksheets
CAS

11. Unique features of the Nuffield Centre Dyspraxia Programme
Created in UK for children with SSD/CAS, 3-7 years
A motor and linguistic approach
Build accurate motor programs for phonemes, words and sentences, supported by picture cues
Establish through repetitive practice
Develop a contrastive system at each phonotactic level (eg C, V, CV, CVCV, CVC)
Work on several targets simultaneously across speech system
Photocopiable pictures/worksheets

12. NCDP: Case Study
Describe the characteristics of child
How was his speech assessed?
Describe intervention and results

13. Stimulability Intervention (Miccio)
Developmental level
Targeted stage of production
Targeted outcomes
Emerging
Developi
Elab
Key components
Tech and/or materials
Specific diagnoses
Plann
Programmin
Execu
Sp Prod
Sp Perc
Phon awareness
Other oral Language
Literacy X
*Stim + nonstim sds targeted
*Sounds paired with alliterative characters and body motions
Alliterative sound character card illustrations ( www. Brookes publishing.com/williams/miccio.htm
Very young children with limited sound inventory

14. Unique features of Stimulability intervention
For young children with limited phonetic inventories who are not stimulable for many or all absent sounds
Major components
Target stimulable and non-stimulable sounds
Speech sounds are associated with alliterative characters
Speech sounds are associated with hand/body movements
Vocal practice encouraged through play-based turn-taking activities
Early success and successful communicative attempts ensured with practice on both stimulable and non-stimulable sounds

15. Stimulability: Case Study
Describe the characteristics of child
How was his speech assessed?
Describe intervention and results

16. Stimulability: Review Questions1)
2) Page 190
3) 2 to 4 years old

17. Levels of Evidence (LOE)
Description
Approach 1a
Well-designed meta-analysis of >1 randomized controlled trial
None 1b
Well-designed randomized controlled study
CV; Cycles; Stim 2a
Well-designed controlled study without randomization
Complexity; Cycles 2b
Well-designed quasi-experimental study
CV; Stim 3
Well-designed nonexperimental studies, i.e., correlational and case studies
CV; Cycles; NCDP; Stim 4
Expert committee report, consensus conference, clinical experience of respected authorities
Cycles