Pediatric+Speech+Sound+Disorders+-+Articulation

=Pediatric Speech Sound Disorders: Articulation = = What is an articulation disorder? =


 * An articulation disorder is described by the American Speech Language Hearing Association as "the atypical production of speech sounds characterized by substitutions, omissions, additions or distortions that may interfere with intelligibility."


 * It is common for most children to have speech sound errors when they are younger due to the fact that certain sounds emerge at different ages. For example, the use of the /w/ sound for the /r/ sound in "wed for red". These errors only become an issue when the child is past the average age of mastery for the sound he or she is misarticulating.
 * The chart below shows the ages of mastery for specific sounds.


 * Speech sound disorders can result from developmental disorders like Autism, genetic syndromes like Down syndrome, hearing losses, or neurological disorders like cerebral palsy. Other speech sound disorders can occur without a �known� cause. The child may not learn how to produce sounds correctly on his or her own. These children may have a problem with speech development.

= Articulation Disorder Diagnosis =


 * The diagnosis of articulation disorder comes from the evaluation of a Speech-Language Pathologist (SLP). Formal articulation testing and careful listening allows the SLP to record any sound errors that are produced. The SLP can also use the Oral Speech Mechanism Screening Examination (OSMSE) which allows the SLP to determine how the muscles of the mouth are working and if they are working correctly. It can be used to evaluate a client's lips, tongue, jaw, teeth, palate, pharynx, velopharyngeal mechanism, breathing, and diadochokinetic rate (a measure of how quickly the child can move his/her articulators from one position to another).


 * Some indicators that a child may have an articulation disorder are sound substitutions, omissions, or additions of sounds. These can become especially problematic after the expected age of speech sound aquisition.


 * ====** Goldman-Fristoe Test of Articulation-Second Edition (G-FTA-2) ** ====



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 * Created by Ronald Goldman and Macalyne Fristoe. The GFTA-2 was published by Pearson Assessments
 * This test can be purchased on many different academic websites. One example, "The Academic Communication Associations: Language, Speech and Special Education Resources for Special Needs" offers this product for around $270.00, with extra record forms costing around $40.00.


 * Brief Description: The GFTA-2 is an articulation test designed for English speaking clients who are between the ages of 2 - 21;11 years old. This test provides the clinician with information about the child's articulation through spontaneous and imitative sound sampling. This test will help the clinician determine the articulation of the consonant sounds as well as help to determine what types of misarticulations the client is producing. There are three different sections to this test: Sounds-in-Words, Sounds-in-Sentences, and Stimulability. The amount of time it takes for this test to be administered varies from section to section. The 'Sound-in-Words' section takes anywhere from 5 to 15 minutes, the other two sections time can vary depending on the client.


 * ===Clinical Assessment of Articulation and Phonology (CAAP) ===




 * Created by Wayne Secord, Ph.D., CCC-SLP and Joanna Donohue, M.A., CCC-SLP.
 * This test can be purchased online from 'Super Duper Inc." for $259.00.


 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Brief Description: The clinical assessment of Articulation and Phonology (CAAP) is for children ages 2;6 to 8;11. This test takes fifteen to twenty minutes to administer and is able to assess a child's articulation and phonology. The test provides the SLP with standard scores, percentile rankings, and age equivalents. This tests allows for the clinician to quickly get an inventory of the children's articulation abilities, measure the overall articulation competence of the child, compare word and sentence levels of school-age children and also to estimate the occurrence of 10 common phonological process patterns in the child's speech.


 * ===<span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">**Secord Contextual Articulation Test (S-CAT)** ===




 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Created by Wayne A. Secord, Ph.D. & Richard E. Shine, Ed.D.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">This test can be purchased through superduperinc.com for $219


 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Brief Description: SLP's can use this test to determine the exact pretreatment status for any particular phoneme or phonological process. It can also be used to evaluate progress during treatment, ensure that treatment is targeted where it is most needed, and it links practice materials to the assessment process. This test will allow you to document the overall effectiveness of intervention and decide with certainty when to dismiss a patient from treatment. It can be used on ages: 4 -Adult.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">For more on articulation assessment tests visit:
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">﻿﻿ASHA Pediatric Articulation and Phonological Assesment Tools

=<span style="font-family: Arial,Helvetica,sans-serif;"> Theoretical Approaches =
 * ===<span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif;">Phonetic placement method: ===
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">The phonetic placement method describes the organ, place, and manner of production of the sound in question to the client. This method would be particularly helpful with clients who are able to maneuver their own articulators by verbal instruction and imitation.


 * ===<span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif; font-size: 11pt; line-height: 115%;">Sound modification method: ===
 * <span style="background-color: #ffffff; color: #000000; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">This method uses a similar sound or sounds that the child can produce in a regular manner as a point of departure for achieving the target sound. For example if the child can produce /t/ it might be used to elicit or achieve /s/ which the child misarticulates. This method is easier to apply if the speech sound chosen as a starting point has certain phonetic similarities to the misarticulated sound. This then creates a bridge between the similar sound that can be correctly articulated by the child and the target sound that is in error.



=<span style="color: #000080; font-family: Arial,Helvetica,sans-serif; font-size: 110%; line-height: 115%;">General Goals of Treatment =
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">The general goals of articulation therapy is for a client to be able to produce speech sounds accurately and clearly at the appropriate age level. The client will also be able to self monitor their speech and self correct when necessary. Through treatment the client should automatically produce the sounds accurately in all positions in daily conversations.


 * <span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif;">**Examples of Long Term Goal:**
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">1. ﻿Child will develop age appropriate articulation for functional communication.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">2. The client will improve on age-appropriate articulation skills to become a more productive communicator.


 * <span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif;">**Examples of Behavioral Objectives:**
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">1. Given pictures and verbal prompts, the client will produce the /s/ sound in the initial position 9/10 times.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">2. During a game of "Go Fish" with /r/ initial, medial, final flashcards the client will accurately imitate /r/ 8/10 times.

=<span style="font-family: Arial,Helvetica,sans-serif;"> Therapy techniques and Activities =

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 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%; margin: 0in 0in 0pt;">**Speech Perception/ Sound Discrimination**: Have the child hear the difference between correct and incorrect sounds. The child listens to the new speech sound and learns how to say it with correct pronunciation.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%; margin: 0in 0in 0pt;">**Phonetic placement**: Mirror, imitative models, verbal instructions, and tools such as straws and tongue depressors are used to focus on articulator placement. An example of this technique would be the clinician imitating the articulator position for the child use a use of a mirror. A possible activity conisists of the clinician modeling a target sound by reading a word or sentence and having the child repeat the speech exactly how the clinician stated it.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%; margin: 0in 0in 0pt;">**Visual feedback**: During articulation practice, tools such as an Electropalatography (EPG), an ultrasound, or a Spectrographic Analysis to view the placement and timing. The EPG shows the timing with electrode placement and the Spectrographic analysis demonstrates the acoustic characteristics of speech.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%; margin: 0in 0in 0pt;">**Minimal Pair activities:** Although phonological, having the child understand the communicative function of the difference of speech sounds. For this to be effective, the child must be able to discriminate sounds. This helps the child generalize production of new sounds to untaught words when they have learned the pairs.

=<span style="color: #000080; font-family: Arial,Helvetica,sans-serif; font-size: 110%;"> Personal Observations: =
 * <span style="color: #000000; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">When observing Speech-Language pathologists I encountered many children with articulation disorders, all at different levels of therapy. Some children were in the beginning stages working on sounds, such as /g/. Other children had moved through sound to syllables such as /go/. During these therapy sessions the activities seemed to contain a lot of repetition. Saying the same sound or letter over and over again during an activity such as the "I spy" games, using Barrel of Monkeys, and homemade game boards. What I remember the most about my observations however was a young girl who had learned how to properly produce the sound /s/, but had not yet begun to use it properly in everyday conversation. When she was completing a reading activity, the page was full of /s/ sounds. The client read the sentence the dog was silly, however it sounded like the dog was chilly. So the clinician asked her why the dog was chilly, and the client realized she had not paid attention to the production of the sound. That was all it took for her to focus and every /s/ that followed was produced wonderfully after that. It was amazing to see the difference in sound when she remembered to change how she produced it.
 * <span style="color: #000000; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">While observing I saw several sessions where the SLP was working on children's articulation disorders. I saw games being played such as memory using words and pictures cards with the target sound in the intial, medial and final positions. One observation that sticks out the most was seeing a child being evaluated to determine whether or not he should begin to receive speech therapy in school. He was in first grade and had not had any other type of intervention previously. The SLP used the Goldman-Fristoe Test. It was interesting to see how easy the test was for the SLP to use because she has done it time and time again. The child seemed to enjoy the testing and forget that he was being evaluated because of her ability to administer it accurately and quickly. Seeing an evaluation of an articulation difficulty was interesting and informative.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">During observation hours, "slow, easy speech" was pushed for clarity and focus on correct articulator placement. Having the child look in the mirror while speaking or using a carrier phrase helps reinfoce correct speech sounds. Having them choose their own game and the therapy session being client-based lets the child feel more in control and elicites better articulation production. Techniques such as reminding of articulator placement, imitation, positive reinforcement, and phonemic emphasis were all used to help the child have a more successful therapy session.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">During an articulation observation the Speech Language Pathologist used pictures and a mirror to elicit the target sound /r/ from a 12 year old child. This sound is usually mastered by 7 to 7.5 years old, therefore considered a speech sound disorder. The SLP gave the child a picutre with the /r/ sound in the initial position like "rabbit". The child was asked to say the word while watching himself in the mirror. The SLP guided the child with phonetic placement as to where his tongue should be placed. The child had a difficult time with tongue placement which explained his problem with /r/ sound. The SLP modeled every word after the child's attempt. The child was aware of his problem with the /r/ sound because he would continue to repeat the word until the SLP gave him feedback. It was interesting to see the SLP's techiniques in explaining to the child where his tongue should be placed.

<span style="color: #000080; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Works Cited:
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<span style="color: #000080; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Section 1: <span style="background-position: 100% 50%; backgroundclip: initial; backgroundorigin: initial; color: #000000; cursor: pointer; font-family: Arial,Helvetica,sans-serif; font-size: 110%; padding-right: 10px;">[] <span style="background-position: 100% 50%; backgroundclip: initial; backgroundorigin: initial; color: #000000; cursor: pointer; font-family: Arial,Helvetica,sans-serif; font-size: 13px; line-height: 19px; padding-right: 10px;">[]

<span style="color: #000000; font-family: Arial,Helvetica,sans-serif; font-size: 15px; line-height: 17px;">Section 2: <span style="background-position: 100% 50%; backgroundclip: initial; backgroundorigin: initial; color: #000000; cursor: pointer; font-family: Arial,Helvetica,sans-serif; font-size: 15px; line-height: 17px; padding-right: 10px;">[] <span style="background-position: 100% 50%; backgroundclip: initial; backgroundorigin: initial; cursor: pointer; font-family: Arial,Helvetica,sans-serif; font-size: 15px; line-height: 17px; padding-right: 10px;">@http://www.youtube.com/watch?v=6OBvfe3iNC4

<span style="background-position: 100% 50%; backgroundclip: initial; backgroundorigin: initial; cursor: pointer; font-family: Arial,Helvetica,sans-serif; font-size: 14px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 10px; padding-top: 0px;">[] <span style="background-position: 100% 50%; backgroundclip: initial; backgroundorigin: initial; cursor: pointer; font-family: Arial,Helvetica,sans-serif; font-size: 14px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 10px; padding-top: 0px;">[] <span style="background-position: 100% 50%; backgroundclip: initial; backgroundorigin: initial; cursor: pointer; font-family: Arial,Helvetica,sans-serif; font-size: 14px; line-height: 21px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 10px; padding-top: 0px;">[] <span style="background-position: 100% 50%; backgroundclip: initial; backgroundorigin: initial; cursor: pointer; font-family: Arial,Helvetica,sans-serif; font-size: 14px; line-height: 21px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 10px; padding-top: 0px;">[]

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 14px; line-height: 21px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">Section 3: <span style="font-family: Arial,Helvetica,sans-serif; font-size: 13px; line-height: 19px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">__ Baumen-Waengle, Jacqueline. (2008). Articulatory and Phonological Impairments: A Clinical Focus. Boston, MA: Pearson Education, Inc. __ <span style="font-family: Arial,Helvetica,sans-serif; font-size: 13px; line-height: 19px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">__<span style="background-color: #ffffff; background-position: 100% 50%; backgroundclip: initial; backgroundorigin: initial; color: #000000; cursor: pointer; font-size: 11pt; line-height: 17px; padding-right: 10px;">[] __

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 13px; line-height: 19px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">__ Section 4: __

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 13px; line-height: 19px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">__ Section 5: __ <span style="font-family: Arial,Helvetica,sans-serif; font-size: 13px; line-height: 19px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">__ http://www.youtube.com/watch?v=yXsf6k5F2l0 __ <span style="font-family: Arial,Helvetica,sans-serif; font-size: 13px; line-height: 19px; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">__ [] __ []