Compelling Case Studies & Research: PROMPT in Action GSHA 2019 - PowerPoint PPT Presentation

Compelling Case Studies & Research: PROMPT in Action GSHA 2019 -- February 15, 2019

Disclosure Statement I have the following relevant relationship in the services described and reviewed in this presentation: PROMPT Institute • Contract employee which entails conducting PROMPT courses and PROMPT Instructor responsibilities.

After GSHA 1977

Learning Objectives • Identify Movement patterns as they apply to the System Analysis Observation (SAO) and Motor Speech Hierarchy (MSH) • Identify Priorities as they apply to the Motor Speech Hierarchy (MSH) and Conceptual Framework (CF) • List and explain Key Features of PROMPT Treatment

What is the PROMPT Institute? 5


 PROMPT INSTITUTE 
 SANTA FE, NEW MEXICO 
 www.prompt.org • A Non-Profit Organization dedicated to improving verbal communication and interactions for children and adults. • Research • Treatment grants • 50 instructors worldwide • Trained 40,000 SLP worldwide • PROMPT in di fg erent languages

Who can o fg er PROMPT treatment? • Only speech-language pathologists are trained by the PROMPT Institute • Four levels of PROMPT education § PROMPT Trained o PROMPT: Introduction to Technique o Bridging PROMPT to Intervention § PROMPT Certified Clinician § PROMPT Certified Instructor

Sample of PROMPT Therapy

What makes “PROMPT” PROMPT? Motor TKP input Speech Assessment Conceptual Treatment Framework Activities 9

What is the PROMPT Technique? TKP input 10

WHAT IS PROMPT? • Prompts for • Restructuring • Oral • Muscular • Phonetic • Targets – A tactile-kinesthetic- proprioceptive (touch- movement) based treatment method

12


 
 
 Levels of PROMPTing Surface 
 Parameter 
 Syllable 
 Complex 


What is the Tactile-Kinesthetic-Proprioceptive input doing to the brain? Physiological (muscular) Refined, stable motor speech control Neurological (motor)

What is the Tactile-Kinesthetic-Proprioceptive 
 input doing to the brain? 
 Clinician acts as which then external to develop/ changes programmer by restructure the output! giving TKP input … connections … PROMPT the entire word • to form holistic construct for the motor plan • highlight transitions from and to target phonemes

Current PROMPT Research Cite: Namasivayam, A. K., Granata, F., Huynh, A., & Van Lieshout, P.H.H.M. (2018). Randomized Control Trial of PROMPT Intervention for Children With Severe Speech Sound Disorders. Presentation at the American Speech-Language-Hearing Association Convention, Boston, USA (November 15–17).

What is the PROMPT Approach? Motor TKP input Speech Assessment 17

Motor Speech Hierarchy Speech Subsystems Systems Analysis Observation

19

Increased/ decreased tone Neurological concerns TONE Postural support 20

Airflow Breath support PHONATORY Phonation/valving CONTROL 21

Jaw stability MANDIBULAR Jaw grading CONTROL Up/down movements 22

23

Medial 1/3 Lip contact Lip-jaw dissociation Independent lower lip LABIAL-FACIAL Retracting CONTROL Rounding 24

Sample Video • Ryan and Lilly 25

Anterior Mid LINGUAL Mid-back CONTROL Posterior 26

27

Sample Video • Will 28

Vocal timing Smooth, coordinated SEQUENCED transitions MOVEMENTS Optimal functioning of all speech subsystems 29

Integration of breath PROSODY support, phrasing, stress, rate, loudness 30

31

32

33

34

• Systems are inter-connected • Analyze the system, find the point of breakdown(s) • Examine as a whole system! • Select 3 subsystems for treatment 35

Look at Movement NOT specific sounds Phonemes are multidimensional- • • Phonation • Jaw • Lips • Tongue 36

Clinical Implication • Consonant and Vowel Combinations • Need to think beyond the syllable shape. • CV o Moo, Ma, Me • VC o On, Eat • CVC o Bop, Beep • CVCV o Dada, Mommy, Puppy, Bye-bye • VCV o Anna, oboe, I do

Trajectory of Words • Vowels • Shift away from traditional articulation from consonants 38

Look at this system! • Lana, 4 years, 10 months • What sounds did you hear? • Now let’s take a look at motor! 39

40

Additional PROMPT Assessment Components Global Domain Analysis • Physical-Sensory • Cognitive-Linguistic • Social-Emotional Knowledge of external environment Determine support strategies 41

Physical Sensory Domain Areas to observe General Assessment Questions Skeletal Structure How does the client’s skeletal structure and muscular development impact movement? Sensation What is the status of the neuromuscular system? How well do the sensory organs function? Neuromuscular Integrity What factors impact global motor and speech motor control?

Cognitive Linguistic Domain Areas to observe General Assessment Questions Perception; sensation, How does the client process discrimination, recognition information and interact with the environment to learn? Concept Formation How does the environment need to be structured for learning? What modifications are necessary for the client to learn?

Social Emotional Domain Areas to observe General Assessment Questions Interpersonal Interactions How does the client express their needs and wants? Trust What communicative functions does the client exhibit? How does the client use significant others to aid in the acquisition of knowledge

What is the PROMPT Philosophy? Motor TKP input Speech Assessment Conceptual Framework 45

The PROMPT Philosophy PROMPT PROMPT Conceptual Holistic Tenets Framework

PROMPT Conceptual Framework Environment External Cultural Physical Physical Sensory Social Cognitive Linguistic Sensory- Skeletal Structure Perception Neuromuscular Integrity Motor sensation interpersonal Sensation discrimination recognition Communication Concept Formation Client intrapersonal Internal Behavioral Social Emotional Outcomes Interpersonal Interaction Trust Hayden 02 47

PROMPT Conceptual Framework 
 Environment External Cultural Physical Physical Sensory Social Cognitive Linguistic Sensory Skeletal Structure Perception Neuromuscular Integrity - Motor sensation interpersonal Sensation discrimination recognition Communication Concept Formation Client intrapersonal Internal Behavioral Social Emotional Outcomes Interpersonal Interaction Trust Hayden 02 4 8

PROMPT is used with Children and Adults Published Papers Speech Sound Disorders ü Developmental Delays Motor Speech Disorders ü • Dysarthria • Apraxia of Speech ü Hearing Impairment Autism Spectrum Disorders ü Fluency Disorders Foreign Accent Modification 49

What is the PROMPT System? Motor TKP input Speech Assessment Conceptual Treatment Framework Activities 50

PROMPT as a System 
 for organizing and executing a treatment plan Develop Goals & Use data from Use SAO & MSH Objectives, Domains to select Motor Motor-Phoneme Evaluation Speech Priorities Targets, Lexicon, Activities

Sessions • Motor goals • Select target motor- phoneme links • Create meaningful and functional lexicon • Embed lexicon into functional, interactive routines/activities 52

Treatment videos

Considerations: 
 Traditional Therapy and PROMPT

What makes “PROMPT” PROMPT? Motor TKP input Speech Assessment Conceptual Treatment Framework Activities 55

PROMPT Pathway to Certification PROMPT Pathway to Certification Certification Certificati on Project Project Bridging – Bridging – Technique Technique to to Intervention Intervention Technique Technique Introduction Introduction Practicum Practicum to to Technique Technique Online Courses/ Mentoring Online Courses/ Mentoring X 56

Questions? 57

THANK YOU! You are welcome to contact me Gayle Merrefield gaylem@promptinstitute.com For additional information please visit www.prompt.org