consistency is key!

My client, J, is 5 years, 5 months old and is still being seen in our clinic, but his frequent absences have proven to be a problem. For our first few sessions, I administered the Goldman-Fristoe 2, as well as the expressive language subtest of the Preschool Language Scale-4 in order to assess J's language and articulation skills. During the testing, I was able to note several of J's articulation errors. Several of the sound's in J's repertoire are not produced correctly, so my supervisor and I had to pick sounds that were more important to acquire/needed in order to work on other errors.

Currently, J's targets in therapy include:

• Initial /'sh'/ in words
• Final /k/ in words
• Initial /f/ in words
• Medial /f/ in syllables and small words
• Correct placement/production of /l/
• Correct placement/production of /j/

(*when targeting /l/ and /j/, we work on placement, and occasional attempts at vocal productions because these sounds have proven to be very difficult and discouraging to J.)

J is still presenting several errors, none of his errors seem to be improving by any noticeable degree, and his attendance at therapy sessions would be beneficial. Results of therapy sessions for J vary from week to week. Accuracy rates continue to fluctuate throughout the semester, and J's errors appear to be inconsistent. I do not doubt that J's mother wants to get all the help she can for her child, but frequent absences have made achieving progress difficult. Overall, J's accuracy rates for his errors have improved, but very slightly.

Due to his frequent absences, obtaining new data and a new direction for therapy has been difficult. I firmly believe that due to the number of times J has missed therapy, he has missed out on the benefits that therapy could provide. Granted, I know I'm not a super-clinician. I haven't been at this whole therapy biz for long, but I know enough to realize that missing out on the services that are provided can definitely hinder the success that could potentially be achieved.

There are several techniques that have been identified that could help transfer success into environments outside of the clinic, and I would like to link this article as the reference to my blog. If I do have the opportunity to see J again before the semester ends, I would like to implement some of these strategies and urge clinicians who word with J in the future to do the same. Hopefully, even though J may miss sessions frequently, he may be able to generalize his accuracy in articulation into everyday life.


Reference:
Mowrer, D. E. 1971. Transfer of training in articulation therapy. [Electronic Version].
Journal of Speech and Hearing Disorder, 36, 427-446.

i wanna check you for (ar)tics...

JD is a 5 year, 3 month old cutie patootie who began therapy for articulation at the WVU speech clinic in the Fall of 2007 after being referred for a diagnostic. He was seen in the diagnostic class, and presented a lot of errors that have proven to be a challenge. He is a very silly boy, and he definitely keeps me on my toes! He is very well behaved during therapy, usually cooperates well enough to do the activities I have planned, but tends to have a few ornery moments. The little boy inside of me understands....sometimes you just have to be silly! :-)

First of all, J presents with several different phoneme distortions. At first, his speech may seem unintelligible to the average listener, but after speaking with him for a couple sessions and "opening my ears," it was much much MUCH easier to follow along with his conversation. I still have a few "HUH?" moments when I just nod and say "that's cool...", but now J is relatively easy for me to understand.

At the beginning of the semester, I administered the expressive language subtest of the Preschool Language Scale-4 (PLS-4) and the Goldman-Fristoe Test of Articulation 2 (GFTA). J's expressive language was excellent! He received a standard score of 108 (70th percentile) on the PLS-4, and actually never obtained a ceiling before reaching the end of the test. However, the the GFTA was a different story. He received a standard score of 44 (<1>

• final /k/
• initial and medial /∫/
• /l/ in isolation (which was recently dropped to isolation because of poor productions!)
• /w/ and /f/ in isolation.
• Along with his articulation errors, I am also making sure to listen for pronoun errors.

So far, things have been going pretty well. J's accuracy levels are fluctuating a bit, but strong productions are staying relatively high, and we're slowly (but surely!) starting to make some progress on sounds that aren't so strong.

I know what you're thinking... Where's the reference to an ASHA article!! Wellllll.... I am a huge fan of child literacy, and (i think this is a given) as upcoming speech and language professionals, we should all begin to consider how children who present with speech/language errors will fare in the schools. This article by Rvachew, Chiang, & Evans, 2007, lays out the facts pretty clearly: kids who begin school with articulation skills that are not well-developed are much more likely that have difficulty acquiring language and literacy skills as they progress through school.

I hope that all parents are as concerned if their children have speech problems. Luckily, J's mother is so interested, desperately wants to be involved, and is concerned about getting him help so he can do as well in school as possible!

Reference:
Rvachew, S., Chiang, P., & Evans, N. (2007). Characteristics of speech errors produced by children with and without delayed phonological awareness skills. [Electronic version]. Language, Speech, and Hearing Services in Schools, 38, 60-71.