NATURALISTIC INTERVENTION FOR PRESCHOOL CHILDREN WITH PHONOLOGICAL - PowerPoint PPT Presentation

NATURALISTIC INTERVENTION FOR PRESCHOOL CHILDREN WITH PHONOLOGICAL DISORDERS Chelsea Schmidt

Background Information  3 year old  Severe phonological disorder  Multiple processes used:  Final consonant deletion  Stopping of fricatives and affricates  Prevocalic voicing  Velar fronting  Cluster reduction  Weak syllable deletion  Idiosyncratic errors

Focused Clinical Question  For a preschool-aged child with a severe phonological disorder, is a linguistic approach or a minimal pair approach more effective in improving intelligibility?

Inclusion Criteria  Inclusion:  Preschool aged children with phonological disorders  1-1 therapy  Linguistic-approach  Communication-centered  Whole-language  Broad-based  Scaffolded-language  Naturalistic  Minimal pair approach  Improved intelligibility  Suppression of processes

Exclusion Criteria  Exclusion:  Studies of low evidence  Different disorder: apraxia, articulation disorders etc.  Non-English speaking or English as a second language

Search Strategy  Databases: Academic Search Premiere  CINAL  ASHA   Search Terms: Severe phonological disorder  Improved intelligibility  Whole-language approach  Language-based therapy  Suppressing final consonant deletion  Play-based therapy  Minimal pair approach  Broad-based intervention/approach/therapy  Treating phonological disorders  Phonological disorder therapy 

Search Results  Studies Located: 172  Title/Abstract Review: 7  Articles Included: 3 Hoffman, P., Norris, J., Monjure, J. (1990). Comparison of process targeting and  whole language treatments for phonologically delayed preschool children. Language, Speech, and Hearing Services in Schools, 21, 102-109. Hart, S., Gonzalez, L. (2009). The effectiveness of using communication-centered  intervention to facilitate phonological learning in young children. Communication Disorders Quarterly, 32(1), 13-25. doi: 10.1177/1525740109333966. Bellon-Harn, M., Credeur-Pampolina, M., LeBoeuf, L. (2012). Scaffolded-language  intervention: Speech production outcomes. Communication Disorders Quarterly. 34(2), 120-132. doi: 10.1177/1525740111425086.

Article Brief: Comparison of Process Targeting and Whole Language Treatments for Phonologically Delayed Preschool Children.  Method:  2 boys aged 4;1  Moderate phonological disorders  Minimal pair approach:  Auditory discrimination  Imitate in words, phrases, sentences, and conversation  Whole-language approach:  Listened to story  Retell the story  Clinician expansions and models after incorrect phonological productions  Results:  Both children improved intelligibility

Article Brief: The Effectiveness of Using Communication-Centered Intervention to Facilitate Phonological Learning in Young Children  Method:  3 children ages 3;7-4;11  Severe phonological disorders  Communication-centered approach:  Storybook reading  2 activities that facilitated naturalistic interactions  Feedback:  Correct: Repeat and acoustically highlight target  Incorrect: Minimal pair and opportunity to self-correct  Results:  Increased intelligibility in 2 children  Maintained results in 1 child at follow-up

Article Brief: Scaffolded-Language Intervention: Speech Production Outcomes  Method:  2 children 4;2 and 4;8  Phonological disorder  Scaffolded-Language Intervention:  Repeated Storybook Reading (RSR)  Same book every session  Read more pages each time  Spontaneous responses or WH- questions to elicit responses  Feedback:  Correct: Expansions  Incorrect: Minimal pair or imitation of target response  Results:  Improved intelligibility in both children

Summary/Key Findings  Linguistic and minimal pair approaches were effective  Used together to improve intelligibility

Limitations  Lack of common vocabulary  Small sample sizes  Low levels of evidence  Lack of recent studies

Clinical Bottom Line  Both the linguistic and minimal pair approaches were effective  Used together  Naturalistic exchanges with minimal pairs as corrective feedback  Further research is needed

Recommendations  Further research should include:  Larger sample sizes  Higher levels of evidence  Comparison of the combination of approaches to each approach separately