1. Analysis and Interpretation

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

3. 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

4. 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.

5. Severity
Degree of a client’s articulation and phonological disorder

6. 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.

7. 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

8. 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

9. 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

10. 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

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

12. PCC
See your book for the actual rules and formula

13. Severity – PCC Process
Examiner makes judgments of individual sounds in continuous speech tape recorded ( 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

14. 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

15. 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

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

17. 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

18. 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

19. 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

20. Developmental Appropriateness
Debate about cognitive abilities

21. 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

22. 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

23. 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

24. 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

25. Treatment

26. 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.

27. 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

28. 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.

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

30. 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.