Background: The client, T, has been attending speech therapy here at WVU for about three years. She is an 8 year old girl. She has been seen for articulation difficulties. Originally she was mostly unintelligible. Most recently she was working on /tS/, /k/, /g/ and /d3/. When I began treatment she was working on carry-over skills and had graduated from her speech therapy at her school.
Treatment: After some initial base rating it was determined that T had well established carry-over of her sounds and that we should focus solely on maintenance. We see T once a week for fifty minutes. In that time the assistant and I listen for correct articulation of all sounds while focusing on other activities. When we originally focused on her sounds she was 100% over 4 sessions so now we get her conversation in as natural settings as possible and see how her carry over is maintained. In the article, Programming Rapid Generalization of Correct Articulation through Self-Monitoring Procedures by Lynn Kern Koegel , Robert L. Koegel , and Janis Costello Ingham , they discuss the importance of self-monitoring in situations outside of the clinic for generalization and maintenance. This is why we try to use different situations with T, like going outside, or talking on the phone. The above mentioned article was in the Journal of Speech and Hearing Disorders Vol.51 24-32 February 1986.
Monday, April 14, 2008
Thursday, February 28, 2008
Semester 2- interesting case
Background: The client, M, has been attending speech therapy here at WVU since last summer. He is a 23 year old graduate student. He complained of not being able to remember how to say multisyllabic words. He was first diagnosed with cluttering because of his fast rate and mumbling words together. After working on his rate and passing several cluttering diagnostic examinations, he was diagnosed with pure apraxia of speech. M will sometimes be able to tell if he is coming up on a word that he will not be able to say it, other times he just struggles with it. He will pronounce the word incorrectly but differently with each try. Sometimes when the word is modeled it can be easier for him to say. He also seems to struggle on where to put the stress on words. This is really giving him difficulty the further along in his academic career he goes.
Treatment: My supervisor and the past clinician were working on repetition of multisyllabic words, both modeled and un-modeled. We try to incorporate words that are relevant to him, such as words that he has to use often when presenting and teaching. This approach is based on the basic principals of neuroplasticity, stating that repetition can help in developing speech in motor disorders. The latest issue of the Journal of Speech Language and Hearing has an excellent article: Translating Principles of Neural Plasticity Into Research on Speech Motor Control Recovery and Rehabilitation. By: Ludlow, Christy L.; Hoit, Jeannette; Kent, Raymond; Ramig, Lorraine O.; Shrivastav, Rahul; Strand, Edythe; Yorkston, Kathryn; Sapienza, Christine M.. Journal of Speech, Language & Hearing Research, Feb2008, Vol. 51 Issue 1, pS240-S258, 19p; (AN 28774003). This article describes neroplasticity and specifically applies it to motor disorders. It can be a bit monotonous, but it is proven to work.
Effectiveness: I am only in my second session with M. He is optimistic and very willing to put forth the effort to make a difference in his speech.
Treatment: My supervisor and the past clinician were working on repetition of multisyllabic words, both modeled and un-modeled. We try to incorporate words that are relevant to him, such as words that he has to use often when presenting and teaching. This approach is based on the basic principals of neuroplasticity, stating that repetition can help in developing speech in motor disorders. The latest issue of the Journal of Speech Language and Hearing has an excellent article: Translating Principles of Neural Plasticity Into Research on Speech Motor Control Recovery and Rehabilitation. By: Ludlow, Christy L.; Hoit, Jeannette; Kent, Raymond; Ramig, Lorraine O.; Shrivastav, Rahul; Strand, Edythe; Yorkston, Kathryn; Sapienza, Christine M.. Journal of Speech, Language & Hearing Research, Feb2008, Vol. 51 Issue 1, pS240-S258, 19p; (AN 28774003). This article describes neroplasticity and specifically applies it to motor disorders. It can be a bit monotonous, but it is proven to work.
Effectiveness: I am only in my second session with M. He is optimistic and very willing to put forth the effort to make a difference in his speech.
Monday, November 26, 2007
Background:
My client, D, is a nine year old male. He is diagnosed as delayed speech and language(DSL). D has been receiving speech and language therapy from West Virginia University Speech and Hearing Center since the summer of 2004. Before he came to WVU, D received treatment at his elementary school. The client has trouble with velopharyngeal closure, syntax, word finding and reading.
Treatment:
D is still presenting a lot of trouble with reading. This seems to be one of his mothers main concerns. Along with continuing to read we have moved on to more simplistic methods. His inconsistency and frustration shows that he may be having trouble with the groupings of words and word families. It was suggested on several education sites to work on word families. There also several articles in which it is stated that working on word families particularly helps out struggling readers. Ones such article is Helping Low Readers in Grades 2 and 3: An After-School Volunteer Tutoring Program Darrell Morris; Beverly Shaw; Jan Perney
The Elementary School Journal, Vol. 91, No. 2. (Nov., 1990), pp. 132-150.
Stable URL: http://links.jstor.org/sici?sici=0013-5984%28199011%2991%3A2%3C132%3AHLRIG2%3E2.0.CO%3B2-Y . We take word family cards and separate them into beginning and ending of words. Then we take turns moving the cards around to try and form words. I also take one or two endings and go over them thoroughly.
Effectiveness: D seems to be catching on to this theory. He still guesses at times and has some trouble remembering the sounds of the words. He does however get a spark every now and again and he takes off. He understands that the words all have the same ending. He needs more practice but I really could see this making a difference.
My client, D, is a nine year old male. He is diagnosed as delayed speech and language(DSL). D has been receiving speech and language therapy from West Virginia University Speech and Hearing Center since the summer of 2004. Before he came to WVU, D received treatment at his elementary school. The client has trouble with velopharyngeal closure, syntax, word finding and reading.
Treatment:
D is still presenting a lot of trouble with reading. This seems to be one of his mothers main concerns. Along with continuing to read we have moved on to more simplistic methods. His inconsistency and frustration shows that he may be having trouble with the groupings of words and word families. It was suggested on several education sites to work on word families. There also several articles in which it is stated that working on word families particularly helps out struggling readers. Ones such article is Helping Low Readers in Grades 2 and 3: An After-School Volunteer Tutoring Program Darrell Morris; Beverly Shaw; Jan Perney
The Elementary School Journal, Vol. 91, No. 2. (Nov., 1990), pp. 132-150.
Stable URL: http://links.jstor.org/sici?sici=0013-5984%28199011%2991%3A2%3C132%3AHLRIG2%3E2.0.CO%3B2-Y . We take word family cards and separate them into beginning and ending of words. Then we take turns moving the cards around to try and form words. I also take one or two endings and go over them thoroughly.
Effectiveness: D seems to be catching on to this theory. He still guesses at times and has some trouble remembering the sounds of the words. He does however get a spark every now and again and he takes off. He understands that the words all have the same ending. He needs more practice but I really could see this making a difference.
Monday, October 15, 2007
Clinical Treatment 1
Background:My client, D, is a nine year old male. He is diagnosed as delayed speech and language(DSL). D has been recieving speech and language therpy from West Vriginia University Speech and Hearing Center since the summer of 2004. Before he came to WVU, D recieved treatment at his elementarty school. The client has trouble with velopharyngeal closure, syntax, word finding and reading.
Treatment: To work on reading in the past, the clinician would help D read a book from home and help him sound words out. He would then have to answer questions on the story. I have decided to havethe client do sometihning new. D is interested in science. I pick out a science project for us to do in therapy. D will read the instructions to me as we do the project. I believe that since he is more interested in the subject matter and it seems fun to him, that he is reading better. He is also trying harder and showing less frustration.
Evidence: In the article cited below researchers address the topic of using games and fun materials to help children (especially those with learning dissabilities) learn. It focuses on motivation of the children adn how it maintains a positive learning environment for the children.
Deacon, H., Kowalyk, S. (2007) 'Not All Fun and Games'. Literacy Today. 22
My supervisor also suggested that we try to do something that would lean more toward his interest. His frustration with reading was growing and she wanted to make it as smooth as possible for him.
It was also very rough for D's mom to see him struggle. It was upsetting to her and she wanted a setting that would be more postitive for him.
Effectivness: D seemed to really respond positivly to the change in treatment. He went from struggling on every single word and guessing, not even using context clues, to sounding out words with ease. He of course sill has some problems and needs help with a few words but the change had been profound. He takes a lot longer to get frustrated now and focuses more on the reading material. I have seen such a vast improvement!
Treatment: To work on reading in the past, the clinician would help D read a book from home and help him sound words out. He would then have to answer questions on the story. I have decided to havethe client do sometihning new. D is interested in science. I pick out a science project for us to do in therapy. D will read the instructions to me as we do the project. I believe that since he is more interested in the subject matter and it seems fun to him, that he is reading better. He is also trying harder and showing less frustration.
Evidence: In the article cited below researchers address the topic of using games and fun materials to help children (especially those with learning dissabilities) learn. It focuses on motivation of the children adn how it maintains a positive learning environment for the children.
Deacon, H., Kowalyk, S. (2007) 'Not All Fun and Games'. Literacy Today. 22
My supervisor also suggested that we try to do something that would lean more toward his interest. His frustration with reading was growing and she wanted to make it as smooth as possible for him.
It was also very rough for D's mom to see him struggle. It was upsetting to her and she wanted a setting that would be more postitive for him.
Effectivness: D seemed to really respond positivly to the change in treatment. He went from struggling on every single word and guessing, not even using context clues, to sounding out words with ease. He of course sill has some problems and needs help with a few words but the change had been profound. He takes a lot longer to get frustrated now and focuses more on the reading material. I have seen such a vast improvement!
Friday, August 17, 2007
Subscribe to:
Posts (Atom)