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The Imagery Approach:
Ideas for Therapy
Susie Mitchell & Josephine Yong
Speech Pathology
School of Community Health
Charles Sturt University
The Imagery Approach
Klein’s (1996a) cognitive approach uses semantic images to describe and teach phonemic contrasts to
children with phonological process errors (e.g., “friendly” and “lonely” to describe cluster reduction.
We believe this intervention approach will be most efficacious for treating Andrew’s speech errors for
the following reasons:
·
“Training broad”, rather than “training deep”, is more appropriate for children who use a number
of phonological processes and are poorly intelligible (Smit, 2004). By targeting a phonological
process, a number of sounds and syllable shapes can be worked on simultaneously, reducing total
treatment time (Bauman-Waengler, 2004; Klein, 1996b).
·
The cognitive learning focus promotes rapid generalisation of learnt skills in children than their
traditional therapies, which primarily focus upon oro-motor learning (Klein, 1996a).
·
The Imagery Approach includes a clear sequence of steps, which Klein (1996a) found easier to work
with than other more ambiguous approaches.
·
It is an approach that capitalises on a child’s vivid imagination, thereby maintaining their interest
and motivation to participate.
We determined that Andrew’s overall goal would be to increase his consonant production to 90% PCC
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in everyday conversations. This will not only increase his intelligibility, but also maximise his ability to
participate in important activities (such as schooling, farming chores, and social play), and enable him
to clearly and effectively express his needs.
Long-terms goals for Andrew include decreasing the occurrence of velar fronting, early stopping, and
cluster reduction to = 10% usage in conversation with the clinician in the clinic. Andrew’s Phonological
Analysis Summary (Baker, 2004) revealed that velar fronting, early stopping, and cluster reduction
were produced in the initial position more than 40% of the time, which Lowe (1994) states is the
qualifying level for intervention. By targeting the word or syllable initial positions, Andrew will
generalise the correct sound usage to other word positions according to Klein (1996). Klein also believed
that priority should be given to processes that contributed most to unintelligible speech. Applying this
hierarchy to Andrew’s case, the order of treatment would be velar fronting, early stopping, and cluster
reduction. We believe that each successful process reduction will positively influence the therapy of
subsequent processes that we are addressing. It is also expected that Andrew’s word shape repertoire
will increase as his phonological process usage declines.
Examples of short-term therapy goals are included in each intervention task. We chose to design a task
for Andrew’s phonological processes of velar fronting, early stopping, and cluster reduction to
demonstrate the versatility of the imagery approach. The approach entails completing seven steps to
treat a phonological process. The fours tasks also demonstrate four of the seven steps involved with the
implementation of the Imagery Approach.
Title:
Task 1 - Imagery: Velar fronting.
Author:
Susie Mitchell
Objective:
Step 1(c) - To teach Andrew to identify both sides of the contrast in nonsense CV syllables with a
number of vowels, beginning with either member of the velar fronting pair /k/ and /t/, using the
semantic labels for velar fronting; ‘front’ versus ‘back’.
Note:
•
Nonsense syllables are used in Step 1 and 2 to teach the new pattern of sound production
without the interference of unlearning his current pattern (Step 3-7).
•
I chose /k/ and /t/ because they were used in Step 1(a) to teach both sides of the contrast,
with one vowel. This was the most contrasting pair revealed in his PROPH+ analysis of
early stopping usage (/k/ [t], /k/ [d], /g/ [d]).
Materials:
A truck, or vehicle, which has an open back and openings in the front (easily made with two small
boxes and two toilet rolls for the wheels).
10 felt lambs (Andrew lives on a farm).
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List of nonsense syllables: /ka/ /ki/ /ku/ /kI/ /koυ / versus /ta/ /ti/ /tu/ /tI/ /to υ/.
Note: The goal is to expand Andrew’s definition of the new labels a little, not identify every
possible combination of vowel and member from each contrast pair for velar fronting.
Procedure:
•
Ask Andrew to put a lamb in the front of the truck when he hears a ‘front’ sound, and in the
back for a ‘back’ sound, saying the label he has chosen as he does so. It does not matter if he
has said the sound incorrectly, as long as you can understand that what he is saying. Note:
Although CV is not technically one sound, this term is used for ease of communication with
Andrew.
•
Reinforce correct identifications with praise, and a reward (e.g., playing with toys and a
sticker) when he gets them 100% correct, that is, for completion of this stage and Step 1.
•
If he gets two wrong in a row, go back to Step 1(b) where only one vowel was used with a
number of members from each contrast pair, or if need be (a) where /k/ and /t/ were used with
the vowel /a/. Add an extra cue to the side of the contrast he is having problems with, for
example, exaggerate the sound and/or action associated with the label. When he produces
these 100% correctly, without cues, return to Step 1(c) .
Title:
Author:
Task 2 - Imagery: Early stopping.
Susie Mitchell
Objective:
Step 4 - Production of both sides of the contrast in words (i.e., unlearn his pattern of
early stopping).
Materials:
Pictures representing both sides of the contrast:
CV/ CVC - foal, farm, fish, sun, Sam (photo of brother), sing, shoe, shell, shave, boy, bee,
bell, dive, doll.
CVC with both sides of the contrast - foot, food, sad, sword, sheep, shed.
Procedure:
•
Ask Andrew what the picture represents. Use CV words, at first, to maximise his
chance of success.
•
If he uses early stopping the first time, look puzzled and say, “That was a “popping”
word. I thought you told me last time it was a “blowing” word. Try to make it a
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“blowing” word.”
•
Wait and see if he corrects himself. Don’t model the word for him.
•
Note: Production of the correct side of the contrast is the goal, so if Andrew, who
usually says [tΛn] for /sΛn/, says [zΛn], reinforce him for being correct. Correct
production of the word is expected in Step 6 (Production of Phrases).
•
If he hasn ’t produced a word using the correct side of the contrast after a two
attempts, go back to Step 3 (Identifying the Contrast in Words), or Step 2
(Production of Contrast in Syllables) if you think that would be more beneficial.
When he is 100% correct at that level, ask him to attempt to “make” the words
again. Reassure him that he can do it because he could produce the sounds in the
nonsense syllables in the earlier step. Be patient while he works on incorporating his
new understanding into his phonolinguistic system. This can take up to three
sessions (Klein, 1996).
•
When he does “get it”, this will generalise reasonably quickly to the other words he
is shown. Reinforce each correct production with enthusiastic praise and a reward,
e.g., a block to build a tower. When 100% correct, he can choose a game to play with
you or his parent.
•
Try more difficult words (CVC/ CVC with both sides of the contrast) if you feel
confident that Andrew can achieve success with them.
Title:
Task 3 – Imagery: Reduction of initial /k/ and /s/ clusters.
Author:
Josephine Yong
Objective:
Step 3 – To teach Andrew to recognise and identify both sides of the contrast of real
words, using CCV or CCVC word shapes. Clusters containing /kl/, /sk/, /sp/, /st/,
and /sm/ will be contrasted with any other CV or CVC word, using the semantic labels
of “friendly” for words beginning with a cluster, and “lonely” for words beginning with
singletons.
Note:
•
Step 3 can only begin after the successful completion of Steps 1 and 2. This is to
ensure the child is able alter his/her pattern of production upon request.
•
Initial consonant pairs containing /kl/ were chosen as “friendly” words, as it was
an extension from Andrew’s newly mastered velar sound of /k/. /l/ was chosen as
the consonant partner because of his ability to produce this sound in initial and
medial positions (see Phonological Analysis Summary). Similarly, clusters
beginning with /s/ were chosen, as the majority of initial clusters begin with this
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phoneme, which Andrew was unable to pronounce at all. Mastering these clusters
would enable Andrew to effectively communicate with his friend Steve, and his
dog Oscar.
Materials:
2 small chairs (or 1 large chair or beanbag), 1 soft toy of Andrew’s choice, and picture
cards displaying simple words beginning with /kl/, /sk/, /sp/, /st/, and /sn/ (e.g., cloud,
scar, spoon, Steve, and snake), along with pictures displaying any CV or CVC words
(e.g., dog, car, sun, bike, and lamb).
Procedure:
•
Place the 2 chairs next to each other, with the soft toy sitting on one of the chairs.
After presenting each picture card with verbal stimulus, ask Andrew to identify
whether the word is “friendly” or “lonely”. If the word is “friendly”, Andrew is to sit
in the chair next to the soft toy. If the word is “lonely”, the toy will be left by itself.
•
Remain in this stage until Andrew can identify both sides of the contrast in real
words accurately.
•
Give verbal praise as reinforcement for correct identifications and a sweet if he
identifies all contrasts 100% correctly.
•
If any problems arise, go back to step 2, where nonsense sounds (containing a
consonant pair with one vowel) were contrasted with any consonant singleton and one
vowel.
Title:
Task 4 – Imagery: Reduction of initial /k/ and /s/ clusters.
Author:
Josephine Yong
Objective:
To teach Andrew to semantically identify contrasting words in phrases. Words
used in Step 3, containing the initial clusters of /kl/, /sk/, /sp/, /st/, and /sm/, are
used in short phrases. The contrasting phrase will contain no word-initial cluster
pairs. The semantic labels of “friendly” will be assigned to words beginning with
a consonant pair, and “lonely” for words beginning with singletons.
Note:
•
Although this step was optional (Klein, 1996), I believe that Andrew
would benefit from the additional practice that this step provides.
Successful identification of the contrasts will result in the speedy
advancement to Step 6, where he would be required to produce the
contrasting words in phrases.
Materials:
20 coloured round pieces of cardboard, with 2 smiley faces or 1 sad face drawn
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in the middle; one favourite toy selected by Andrew; and picture cards
displaying simple words beginning with /kl/, /sk/, /sp/, /st/, and /sn/, and any
pictures displaying CV or CVC words. The words in Step 3 could be reused with
different pictures, or new words (e.g., clock, sky, spade, star, snail) could be
presented.
Procedure:
•
Arrange the cardboard pieces to form a pathway. Place the toy at one end of the
path. This is a game involving both Andrew and his mother/father.
•
Andrew is shown one of the picture cards, with simple spoken phrase about that
picture. For example, a picture of a star may be presented with the phrase “I see
a star.” Andrew is then asked to identify whether the word is “friendly” or
“lonely”. A correct answer for a “friendly” word would enable Andrew to step
(or jump!) onto the next smiley face. The incorrect answer would result in
Andrew staying where he is, and his parent stepping onto the next sad face. First
person to the end plays with the toy.
•
The parent may also make deliberate ‘errors’ in their pronunciation of
consonant clusters (e.g.: “I see a tar”). If Andrew corrects or identifies the
‘error’, then that would be rewarded as a correct response, allowing him to
move to the next smiley face.
•
If problems arise, return to Step 4, where production of both sides of the
contrast in words is made.
Note:
•
I involved Andrew’s parent/s in this activity to provide support through a
communication partner who is an important part of his everyday life. Klein
(1996) also believed that using people in the child’s natural speaking
environment for speech and language intervention enhanced preschoolers’
communication.
References:
Baker, E. (2004). Phonological analysis summary and management plan. ACQuiring Knowledge in Speech, Language
and Hearing, 6, 14-21.
Bauman-Waengler, J. (2004). Articulatory and phonological impairments: A clinical focus (4th ed.). Boston, MA:
Pearson Education.
Klein, E. S. (1996a). Clinical phononlogy: Assessment and treatment of articulation disorders in children and adults.
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San Diego: Singular.
Klein, E. S. (1996b). Phonological/ traditional approaches to articulation therapy: A retrospective group comparison.
Language, Speech, and Hearing Services in Schools, 27, 314-323.
Lowe, R. J. (1994). Phonology: Assessment and intervention applications in speech pathology. Baltimore: Williams &
Wilkins.
McLeod, S. (2003). Selecting intervention targets. Hobart: Charles Sturt University.
Smit, A.B. (2004). Articulation and phonology resource guide for school-age children and adults. New York: Thomson
Learning.
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