The 4th Annual “What to Do on
Monday Morning”
Articulation A to Z Treatment Tool Kit
Speakers:
Ruthann Aull, BA, SLPA, Pasadena Unified School District
Rebekah Taylor, MA CCC-SLP, Pasadena Unified School District
Lesley Mayne, PhD, CCC-SLP, California Baptist University
Housekeeping
• Cell phones on silent/vibrate
• Please step out if you need to answer
• Restrooms located
• Please take care to sign in at the beginning and sign out at the end
in order to receive your CEU credit.
• Evaluations
Disclosures
• We are receiving a stipend for this presentation
• We receive no compensation from any source to create or promote
products
Today’s Topics
Developing an Articulation Tool Kit
• Articulation vs. Phonology - Does it matter?
• Looking at goals and keeping data
• What’s working? How to look at more than just a sound target
Use of Articulation Tool Kit for Traditional Speech Therapy
• Articulation warm-up tips
• Traditional articulation
• Contrast therapy
• Cycles approach
Use of the articulation tool kit to address core vocabulary and language goals
Developing an Artic Toolkit
Asking Ourselves the Right Questions
Question #1
Is it Articulation or Phonology?
Does it really matter?
Articulation – Actual production
of the speech-sound/phoneme;
restriction or momentarily
blocking the exhaled air in the
vocal tract using the tongue,
palate, teeth, and lips
(articulators).
Phonology – Sound system;
Cognitive and theoretical
concepts of the nature,
production, and rules for
producing and combining
speech sounds in language.
Caroline Bowen, PhD, CCC-SLP http://speech-language-therapy.com/
• Targeting a single sound, one
at a time
• Student and Family names
Question #2
Which strategies are going to
make the most difference for my
student?
• Core vocabulary and
Functional phrases
• Targeting a phonological
process or a specific class of
sounds rather than just one
sound
• Stimulability
Question #3
How do I interpret these goals?
What do these goals even mean?
• Differences in writing styles
• SMART Goals
• What to do when there is more
than one target sound in the
goal
• Accuracy? Trials? Help!
• Data collection... with what?
Essential Goals Parts
(http://www.sonoma.edu/users/p/phelan/423/carsgoals_files/Overview.pdf)
Who - Student
Does what - Observable behavior
When - By reporting date
Given What - Conditions that need to be in place in order for the goal to be met
Criteria - How many times you want to see the behavior in order for the goal or
objective to be completed (# of trials; level of prompting)
Mastery - How often will the behavior be observed (e.g. across two consecutive
sessions; often seen in goals as a percent of time
Performance Data: As measured by treatment notes, charted data, portfolio, etc
How SMART is the goal? A General Profile
Specific = Who? Does what? sound, position, what supports
Measurable
Criteria = trials, level of prompting
Mastery = consecutive # of sessions; % accuracy
Performance criteria= as measured by data collection
Attainable = Does this seem reasonable?
Relevant = How is this a functional outcome?
Timely = By Jan 9, 2016; 2/3 consecutive treatment sessions
Goal Example: What are our options?
Baseline: Joe uses multiple phonological processes to simplify his
speech output (fronting, stopping of fricatives, gliding).
By Jan 9, 2016, Joe will produce age-appropriate sounds
(w,h,m,b,p,t,d,k,g,f,s) at the beginning and ends of 10 single words
80% of the time given moderate prompts/cues in 2/3 consecutive
treatment sessions as measured by data collection.
How SMART is the goal? Application
Specific = age-appropriate sounds, beginning and ends of single
words, moderate prompts/cues
Measurable
Criteria = 8/10 trials
Mastery = consecutive # of sessions; % accuracy
Performance criteria= as measured by data collection
Attainable = Does this seem reasonable?
Relevant = functional outcome
Timely = By Jan 9, 2016; 2/3 consecutive treatment sessions
Goal Comparison
By Jan 9, 2016, Joe will produce age-appropriate sounds
(w,h,m,b,p,t,d,k,g,f,s) at the beginning and ends of single words
with 80% accuracy given moderate prompts/cues in 4/5 trials.
By Jan 9, 2016, Joe will produce back sounds /k/, /g/ in the initial and
final position of words in five trials 80% of the time given moderate
prompts/cues in 2/3 consecutive treatment sessions as measured
by data collection.
Question #4
How do I pick my targets?
• Think in sounds, not letters
• What is the typical age of
acquisition for these targets?
Which come first?
• Are there phonological
processes or a few, specific
sounds?
• Are errors made in particular
class of sounds?
• Don't choose words with the
target sound that also contains
the substitution
• How old is this student?
Question #5
• Target
• Level of Prompts/Cues
• Specific and consistent
symbols
How will I collect my data?
What data do I collect?
• Set number of items
established for your trial
• How many trials are you
attempting?
http://speechymusings.com/about/
http://speechymusings.com/2014/01/2
8/free-data-sheets-round-up/
• Toys
• Let’s make something!
Question #6
What materials will I use?
• We can always play a
game
• Storybooks and speech
sounds
• Drills
• Textbooks/Readers
• Whatever you have!
Webber Card Therapy Tips
Stand By
Place articulation cards or minimal
pair cards on the floor
Use positional concepts to have
students Stand By a card
in front of
next to
between
Prompt: What are you standing
by?
Right On!
A version of Mother May I
Student stands before a line of target
picture cards
The student states, May I step on the
_____.
If the production is correct the child
advances. If the production is
incorrect the child goes back to
the beginning.
Using Our Toolkit for
Traditional Artic Therapy
Using Strategies and Asking Yourself
More Questions
Strategy #1
Articulation Warm-Ups
• Vowels
• Vowel to consonant
• Consonant to vowel
• Resonation & Respiration
awareness
Testy Yet Trying
http://testyyettrying.blogspot.com/2012/04/speech-card-setactivity-old-maid.htm l
Question #7
What’s working for the child?
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•
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•
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Prosody
Placement
Isolation
Syllable Shape
Respiration
Resonation
Phonation
Articulation
What’s working: Respiration
Materials for WarmUps:
Whiteboards are
amazing!
Example:
Consonant to Vowel
Vowel to Consonant
A Resonation Image to
Use in Therapy
The anatomy of producing sound
● Respiration - breathing
● Resonation - larynx, pharynx, oral,
nasal, bony structures
● Phonation - voiced/unvoiced sound
production
● Articulation - place, voice, manner
Warm Up Script
1.Put your resonation head image in a sheet protector
2.Use one highlighter color to write where the place of the target sound is
produced
3.Consider placing a blank piece of paper in a sheet protector and taping it
below the resonation image. You can draw lungs or find an image of ribs and
lungs and draw where breathing or respiration originates. Talk about
clavicular, thoracic, and diaphragmatic breathing
4.Use a third marker to highlight areas where voicing or phonation is or is not
occurring
5.Have the client identify/feel in their body where resonation is occurring. Use
another highlighter to color resonation pattern
6.Use any inspired design to work on articulation in isolation, CV, or VC
Strategy #2
Using the Hierarchy
Nuffield Dypraxia Programme: About. (2014). Retrieved
December 1, 2015, from http://www.ndp3.org/dyspraxia-apraxiatreatment-approach.html
• CV combinations
Question #8
What’s working in the syllable
shape department of speech
production?
• CV or VC?
• We just started and they can
produce the target in a CVCV
word. Do I keep working on
CV?
Strategy #3
• Imagery
• Kinesthetic prompts
• Tactile prompts
Eliciting sounds
• Using apps and visual support
Vowel Activity Page
http://blog.maketaketeach.com/how-to-make-vowel-sticks/
1. Print the vowel stick activity page on cardstock,
laminate it, and cut out each circle
2. Glue gun each circle on the end of a large craft
stick
3. Write three to five vowels on the stick and put a
dot on the back of the stick indicating the correct
vowel answer
4. Place a star on the end of a clothespin
5. The child will name the icon and clip the clothespin
on the vowel. If the dot on the back of the craft
stick is covered the child identified the correct
vowel
Wayne Secord /s/ and Mayne Variation Tips
Phonetic placement
• Tongue tip approximated at
the alveolar ridge
• Tongue tip down and the mid
tongue makes contact at the
alveolar ridge
Sound approximation
• /t + s/ across word position
• Reduce plosion - soft contact
• Tongue on the the teeth or
alveolar ridge and breathe another soft contact technique
• Long /s/ - another respiratory
control technique
Production Strategies for /r/
• Pretend you are a puppet
• Think about a string being pulled from the top of
your head lifting your tongue up for /r/
• Think about a string being pulled from the back
of your head pulling the tongue back
• Dental floss
• Literally use a piece of dental floss. Loop the
floss around the tip of the tongue. The client
retracts their tongue tip while voicing /r
• /l/ elicitation - start with an /l/ and bounce or drag the
tongue tip back to an /r/
Tongue Curl: Use
your muscles!!!
Mrs. Herd’s Speech Blog
http://hurdspeech.blogspot.com/2013/12/twoways-to-make-r.html
• Reciting finger plays (e.g., itsy-bitsy
spider) and nursery rhymes (e.g., hey
diddle-diddle)
Strategy #3
• Singing songs, chants with rhyming or
alliterative schemes
Phonological Awareness
• Using colored blocks to mark the
beginning, ending, and middle sounds
• Word families & Rhyming
• Segmenting words (cowboy – boy =
cow)
Strategy #4
Contrast Therapy:
Minimal Pairs
Education Speech Language Program App Support Sight
https://ieslp.wordpress.com/s-speech/sth-minimal-pairs-and-stminimal-pairs/
Question #9
What’s my motivation to use
contrastive therapy like minimal
pairs?
• Increase Student Self
Monitoring and Correction
• Generalization
Minimal Pairs Theory: What I Need to Know
• Developed by Weiner, 1984; Barlow & Gierut, 2002; Gierut, 1990
• Target children with compromised intelligibility due to many phonological
processes
• Targets more the mild to moderate cases
• Children with consistent sound production errors
• Better for children with substitution errors
• Perceptual knowledge is often intact (dependent on population being served)
• Contrast therapy addressing phonological errors using 3-5 exemplars
• Focus on changing classes of sounds rather than one sound
Minimal Pairs: Two Types of Intervention Hierarchy
Meaningful Minimal Pair Intervention
Step 1 Familiarization
Step 2 Listen and Pick Up
Step 3 Production of Minimal Pairs
Notes: Continue at the word level until
generalization criteria has been met. Identify 5
exemplars. Complete 20 trials. Total of 100
trials. Use different activities every ten minutes
to elicit productions (e.g. barrier games,
magnetic fishing, shopping for cards, etc.)
Perception Production Minimal Pair Intervention
Step 1 Familiarization and Perception Training state each 5 exemplar word pairs to the child twice,
the child sorts the words by phoneme with 90% ac.
Step 2 Production - Word Imitation - 50 trials with
90% accuracy with corrective feedback
Step 3 Production - Independent Naming - 50%
accuracy in 50 trials,offer praise and instruction but
no modeling
Step 4 Production - Minimal Pairs Production
Place Voice Manner Chart
Minimal Pairs: Generalization from Day One
• Visual
• Resonation image
• Video record the student and playing back to self-monitor
• Verbal “The words sounded the same. How can you say the sound
differently?”
• Auditory - Audio record playback
• Prosody - Use melodic intonation within the word, phrase, or
sentence
• Attention - Use reading activities, highlight the target sound
• Peer Monitoring - Using peers during group sessions
• Adult Support - Reminders in all settings (e.g. classroom, home,
coaches, music, art, etc.)
Strategy #5
Cycles Phonological
Remediation Approach
Speech and Language Kids
https://www.speechandlanguagekids.com/how-to-use-the-cyclesapproach-for-speech-therapy/
Question #10
What’s my motivation to use a
cycles phonological remediation
approach?
• System Wide Change
Cycles Phonological Remediation Approach:
Underlying Concepts
• Phonological process acquisition is gradual
• Children learn sounds by hearing (Van Riper, 1939) so emphasize target
sounds in words
• Children associate kinesthetic and auditory sensation as they acquire new
patterns enabling later self-monitoring so focus on successes
• Phonetic environment can facilitate or inhibit correct sound productions so take
advantage of a place, voice, manner chart
• Children are actively involved in their treatment using experiential play
• Children tend to generalize new speech production skills to other targets so
focus on blends and cognate pairs (e.g. /st/ facilitates /s, z, t, d/)
• Children that are stimulable for sound productions facilitate a child’s learning
The Phonological
Processes Tree
● Substitution processes
○ Backing “pak” for “pat”
○ Fronting “tootie” for “cookie”
○ Gliding “yeyow” for “yellow”
● Assimilation processes
○ Assimilation “bub” for “bus”
○ Denasalization “pick” for “pig
● Syllable structure
○ Cluster reduction
○ Final consonant deletion
○ Initial consonant deletion
○ Weak syllable deletion
Case Study: Joey age 5:7
Profile
Therapy Plan - Cycle #1
/p, b, t, d, m, n, w, j/
1. Word final consonants /t, d/
No final consonant productions
2. /s/ clusters
No consonant clusters
3. Velars - word initial /k, g/, word
final /g/
One intelligible word - daddy
4. Pre-vocalic liquids
Childhood Apraxia of Speech profile
Case Study: Joey Age 5;7
Cycle #2
1. /s/ clusters incorporated into
carrier phrases
2. Liquid clusters /kr, gr/
3. Medial and final clusters /kw, kj/
as in quick and cue
Cycle #3
1. Liquids
2. Palatal sibilants = palatal
fricatives and affricates = “sh”,
“dge”, “ch”
3. Expanded cluster repertoire
Phonological Processes Cycles Approach
Session Priorities
1. Determine the primary target
priorities
2. Target a phonological process for
60 minutes
3. The number of processes
included in one cycle is
dependent on the severity of the
child’s intelligibility.
Primary Target Priorities
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•
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Omissions of sounds
Omission of syllables
Initial position singleton consonants
Final voiceless stop consonants /p/, /t/,
/k/
• /s/ clusters
• Contrast anterior to posterior sounds
/t, d/ to /k, g/
• Liquid sounds /r/, /l/
Using our Artic Toolkit to
Support Language
Trying New Things and Still Asking Questions
Strategy #6
Core Vocabulary Approach to
Articulation
Question #11
Global Communication:
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What’s my motivation to use
core vocabulary approach to
articulation?
Listening
Speaking
Reading
Writing
Core Vocabulary Target Population
•Children with inconsistent speech sound disorders
Trouble with phonological assembly
•10% of children with speech sound disorders have inconsistent productions
•Multiple errors
•Pervasive speech processing difficulties (*pervasive does not spell check: does
perseverative work?)
Alternative option: Use for children with all speech sound disorders because this
approach uses established core curriculum
Differential Diagnosis of Childhood Apraxia of
Speech and Inconsistent Speech Disorder
Cognitive Linguistic Processing
•Lexical impairment - children seem to have semantic knowledge and awareness
but could not access the phonological shape of the word
•Linguistic knowledge – stronger phonological knowledge than production skill
•Output processing – motor planning challenges
•Interpretation – challenges with phonological planning not phonetic planning – no
oral motor issues
What Words Should I Choose? Consider Severity
• SDC
• AAC core vocabulary handout http://www.vantatenhove.com/papers.shtml
• Make a list of words
important to the child
• RSP and Speech Only
• Spelling lists
• Vocabulary lists
• Reading work
• Homework
Core Vocabulary Practical Requirements
•Sessions 2 x week 30 minutes
•70 pictured words are determined by known communication partners and include names, funcional
words, favorite things, places, hobbies - focus on interest not word shape
•10 words are trained in session one
•The same ten words are trained in session two with focus on drill and revision to maximize the best
production
•Words produced with consistency (not necessarily articulatory accuracy) are removed from the list
and words not met with mastery are continued
•Additionally ten untreated probes or words removed from the core 70 are elicited three times to monitor
generalization every 14 days.
•Dosage = 16 sessions to train 70 words
Strategy #7
Division of Roles & Homework
• Daily practice by parents and
teachers focusing on the
elements that are identified to
maximize production
• Clinician targets the best
possible production for 10-12
targeted words from the list of
70 words
• Clinician trains the parents on
reinforcement
• Clinician must account for
behavior and speech
production limitations
Take Away Ideas
1.Goals - Attend to the criterion and mastery of a goal
2.Articulation Warm Up Tips - What’s working and what can I support in the area
of respiration, resonation, phonation and articulation
3.Traditional Articulation - Check out the blogs and try a new tip
4.Contrast Therapy - Use 3-5 exemplars, self monitoring, generalization
5.Cycles Approach - Use with compromised intelligibility cases
6.Core Vocabulary - Connect curriculum/functional language to therapy
7.Phonological Awareness - Build metalinguistic and literacy skills
Articulation Toolkit – Index
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•
Slides 5-16
Slides17-29
Slides 30-32
Slides 33-35
Slides 36
Slides 37-42
Slides 43-49
Slides 50-58
Goals, targets, and materials
Resonation, respiration, phonation, articulation
Artic hierarchy
Vowels
Phonological processes
Minimal pairs
Cycles approach
Core vocabulary approach for articulation
Websites We Like
www.thespeechroomnews.com
www.mommyspeechtherapy.com
www.teacherspayteachers.com
www.kidzone.ws
www.dltk-kids.com
www.speechiefreebies.com
www.speechtimefun.com
www.speechymusings.com
www.slpity.blogspot.com
www.letsgrowspeech.com
www.themeasuredmom.com
www.busybugkits.com.au
www.speechsproutstherapy.com
www.speechspotlight.com
www.thecoloringspot.com
www.smartappsforkids.com
www.speechtherapyideas.com
www.speakingofsheep.com
For a $35 ($45 AUD) CD on Core Vocabulary visit Grow Words at
http://www.growwords.com.au/
Closing
• Questions? Your turn!
• Did we meet your expectations?
• Evaluations! What would you like
to learn at our 5th Annual? Please
let us know specifics! (My request
will be Contrast Therapy)
• RAFFLE! Special Thanks to
Michelle Linares--Learning Grove,
Sherman Oaks
References
Association of School Administrators (2007, January). Handbook of goals and objectives related to essential
state of California content standards. Retrieved from
http://www.sonoma.edu/users/p/phelan/423/carsgoals_files/Overview.pdf
Bowen, C. (2017, January 10). Speech-language pathology dot com: Articles, freebies, links, wordlists,
worksheets. [iVent Services - Blog Post]. Retrieved from http://speech-languagetherapy.com/index.php?option=com_content&view=article&id=3&Itemid=108
Clark, C. (2015, November). How to use the cycles approach for speech therapy. [Maximum Medium, Inc. Blog Post]. Retrieved from https://www.speechandlanguagekids.com/how-to-use-the-cycles-approach-forspeech-therapy/
Crosbie, S., & Wandschneider, S. (n.d.) Grow words: Core vocabulary. [MyWork Australia - Blog Post].
Retrieved from http://www.growwords.com.au/Order-QUIL-and-Core-Vocabulary-CDs-o/
Hurd (2013, December 23). Mrs. Hurd’s speech blog: Two ways to make a /r/. [Blogger - Blog Post]. Retrieved
from http://hurdspeech.blogspot.com/2013/12/two-ways-to-make-r.html
Klein, E. (1996). Phonological/Traditional Approaches to Articulation Therapy: A Retrospective Group
Comparison. Language, Speech, and Hearing Services in Schools, 27, 314-323.
References
McIntosh, B., & Dodd, B. (2008). Evaluation of core vocabulary intervention for treatment of inconsistent
phonological disorder: Three treatment studies. Child Language and Therapy 25(1) 9-30.
Raubenheimer, I., & Martin, C. (n.d.) Education speech language program app
[Word Press - Blog Post]. Retrieved from https://ieslp.wordpress.com/
Roth, & Worthington. (2016). Treatment Resource Manual for Speech Language Pathology (5th Ed.) Delmar
Learning.
Roth, F. (2015, August 5). Advancing Phonological Awareness to Improve Literacy Outcomes. Lecture
presented at Language & Literacy.
Secord, W. (2007). Eliciting speech sounds: Techniques and strategies for children. Clifton Park, NY: Delmar
Cengage Learning.
Speech Musings (2015). Freebies http://speechymusings.com/ . [Georgia Lou Studios - Blog Post] Retrieved
from https://www.teacherspayteachers.com/Store/Speechy-Musings/Price-Range/Free
http://speechymusings.com/about/
References
Testy Yet Trying (2012, April 17). Speech card set: Old maid speech articulation version. [Blogger - Blog
Post]. Retrieved from http://testyyettrying.blogspot.com/2012/04/speech-card-set-activity-old-maid.html
Tobii Dynavox. (1981–2016). The Picture Communication Symbols (Version 6). [Software]. Available from
www.mayer-johnson.com
Van Tatenhove, G. (2013). Papers and resources: Vocabulary lists and checklists. [Blog Post]. Retrieved from
http://www.vantatenhove.com/papers.shtml
Vanalst, J. (2012, June 9). Make, take, and teach hands on activities for the primary classroom: How to make
vowel sticks [Bit Social Media - Blog Post]. Retrieved from http://blog.maketaketeach.com/how-to-makevowel-sticks/
Webber, S. G. (1996). Webber Phonology Cards Game Ideas. Greenville, SC: Super Duper Publications Inc.
Williams, A. L., McLeod, S., & McCauley, R. J. (2010). Interventions for speech sound disorders in children.
Baltimore, MD: Paul H. Brookes Publishing Co.