Bootstrap Turner Jr.Laura Stidham, Mickey Harrison, Nathan Webb

Background Information6 years 2 month old maleBorn 32 weeks gestation

aboard the Black PearlDue to forceps delivery his left

eye was gauged and rendered unusable

SymptomsReferred by his first grade

teacher Jack Sparrow due to speech sound concerns

Evaluation date: February 19, 2010

Bootstrap is blind in his left eye but unremarkable in his right eye

Pure Tone Audiometry was administered which resulted in his hearing being within normal limits

Speech Concerns Low speech production in a natural

environmentMain speech concerns include /s/, /l/, /f/,

/sh/, /ch/, /j/, /z/, and /r/.Also has increased difficulty with plurals and

word endings related to past tenses such –ing, and –ed

Receptive speech is normalExpressive language concerns

Phonological DisorderFailure to use speech sounds appropriate for

the individual's age and dialectLevels of severity range from completely

unintelligible, to speech that can be understood by everyone with just slight mispronunciations

Treatment is important for the child's development and is best treated as early as possible

Children who have problems with speech will likely have problems in their class rooms in subjects such as reading and writing.

Phonological Disorder SymptomsFailure to produce and use sound

appropriatelySubstituting one sound for another Omitting sounds

Assessments

Goldman- Fristoe Test of Articulation- Second Edition

• Ronald Goldman & Macalyne Fristoe• Assesses individual’s articulation of consonant

sounds• Samples spontaneous and imitative sounds

• Contains three sections: Sounds-in-Words, Sounds-in-Sentences, and Stimulability

• Tests individual’s 2-21 years of age• An untimed assessment

– Sections can be completed in 5-15 minutes, however this estimated time is dependent upon the individual

GFTA-2 ScoringUsing the individual’s age (year and month) find the section that

corresponds in Appendix BFind the raw score (equal to total number of errors individual made) down

the list and go across the columns to find the standard scoreBe sure to record the correct gender score! Bootstrap displayed 36 errors out of 77 when given the Sounds-in-Words

subtest of the GFTA-2. His raw score of 36 translates into a standard score of 52 which shows that

Bootstrap has fallen below the average range which denotes a moderate articulation disorder

The average range is 85-115. His dominant errors were created when he produced consonant clusters in

the initial word position and deletion of final consonants.

GFTA-2Pros

New artworkRacial and gender

balancedWidely used for over

30 yearsResponse form

Allows examiner to compare responses simultaneously

ConsVowels are not

assessedIs not printed in all

other languages

Hodson Assessment of Phonological Patters (HAPP-3)Author : Barbara Williams

HodsonThe HAPP-3 is a test designed for

children with highly unintelligible speech.

The age range is for children 2 years old and up and there is normative data for children between the ages of 3 and 8.

Testing time is 15 to 20 minutes for the comprehensive assessment and 2 to 5 minutes for the screening.

HAPP-3 continued

The HAPP-3 kit includes: Examiners Manual, Comprehensive Phonological Evaluation Record Forms, Major Phonological Deviations Analysis Forms, Substitutions and Other Strategies Analysis Forms, Preschool Phonological Screening Record Forms, Multisyllabic Word Screening Record Forms, Multisyllabic Word Screening Picture Sheet, 30-piece object kit, and 13 picture cards.

HAPP-3 screening

Bootstrap was administered the 5 minute screening of 12 stimulus words: boats, fork, glasses, gum, leaf, rock, soap, spoon, star, watch, zip, and nose.

To pass the screening he would have to meet 5 of the 6 criteria questions.

Unfortunately Bootstrap only met 2 of the 6 criteriaBecause he did not pass the screening, I

administered the full comprehensive phonological evaluation.

HAPP-3 Comprehensive Phonological Evaluation

The full evaluation is scored by a raw number score that fits into four categories: mild, moderate, severe, and profound.

1-50 mild51-100 moderate101-150 severe>150 ProfoundBootstrap was tested on 50 words similar to the

screening words and scored a raw score of 68 which labeled him as having a moderate phonological disorder.

HAPP-3 Pros: Use of three dimensional objects. (Children are

more apt to pay attention to objects than pictures).Can be administered in 20 minutes or less.Has a pre-screen assessment.

Cons:For English speaking children only.Only tests for highly unintelligible speech.

Test of Early Language DevelopmentTELD-3

Wayne P. Hreskd, P. Kim Reid, Donald D. Hammill

Norm Referenced; Standard scores, percentiles, and age equivalents

Area of Assessment: Receptive, Expressive and overall spoken language in children

Age Range: 2 years – 7 years 11 monthsSpecific Skill areas assessedTypically test is administered between

15-40 minutes depending on the child’s age and ability

TELD-3 ScoringBootstrap revealed a raw score of 30 for the

receptive language subtest yielding a quotient score of 100 and raw score of 32 for expressive language yielding a 94 from the quotient score. Sum of quotient score was 194. Spoken language Quotient score was 96

Receptive subtest revealed that Bootstrap falls in his age category of 6 years 2 months

Expressive subtest revealed that Bootstrap fell in the 5 year 2 month range displaying a mild to moderate expressive language delay

TELD-3Advantages and Disadvantages

Advantages DisadvantagesContains Receptive and

Expressive SubtestsNew colored pictures Adequately evaluates

children at upper and lower age ranges by using new items that are age appropriate

Useful in targeting children who may be prone to later academic failure

Complicated to ScoreBias on test items

relative to gender, disability, racial, socioeconomic, or ethnic groups

Could not find percentiles from subtests

Bootstrap’s ScoreGFTA-2 Raw score: 36 Standard

score: 52

HAPP-3 Score 68 Moderate Phonological disorder

TELD-3 Receptive: 3o Raw score; 100 quotient scoreExpressive: 32 Raw score; 94 quotient score Spoken Language Quotient: 96

Mild to Moderate expressive language delay; fell in 5 year 2 months age category; Normal Receptive language abilities

Treatments

Parents and Children Together(PACT)

Designed for 3-6 year olds who are unintelligible and have delayed and/or disordered speech

Focuses on phonemes at word level or above in order to expand child’s accuracy with regard to consonants, vowels, syllable shape and stress

Sessions are individual in nature 50 minutes

Parents/ Caregivers play an extremely important role According to McCleod and Bleile, “The incorporation of parental support

into the intervention practices is frequently a key to success.” (2004, p. 210)

Use of Quick Screener is available online

PACTGreat choice for Bootstrap because:

Incorporates parentsTargets intelligibilityFalls within age range for which it was

designed for

PACTPros

Family centeredCost efficientUsed with other client

populationsIncorporates technology

ConsSome questions cannot be

answered(i.e. effectiveness,

efficiency, and validity)

Relies on individual and family to overall success

Individual will and materials (internet)

Minimal PairsMinimal pair consists of

two monosyllabic words that differ in sound by only one feature (e.g., key – pea, big – bug)

Closed-set test of speech feature discrimination

Target items were presented in a live-voice auditory- format

Bootstrap was asked to point to only one of the two pictures corresponding to what he perceived

Minimal PairsAdvantages DisadvantagesImproves client‘s

understanding of word meanings

Oldest, most well-known, and widely used treatment

Served as basis from which other intervention approaches have developed

It is suggested that minimal pair research needs to better establish the effectiveness of the approach, beginning with children with a mild or mild to moderate phonological impairment without any associated difficulties

Minimal Pair TreatmentGreat for Bootstrap because:Treats mild or mild-

moderate phonological impairment

Helps client see a need to produce a contrast between word pairs

Increases vocabularyDecreases final

consonant omissions

Multiple Oppositions

Is a variation of the minimal pars contrastive approach that takes a holistic approach and addresses moderate to severe speech disorders in children with highly unintelligible speech.

Focuses on system wide change. Addressing child's error rule as a whole unitTargets multiple substitutions at the same time. (Phoneme

Collapse)Used for children who have multiple sound errors

Multiple OppositionsSubstitution errors

Consonant production: tea: key, see, she Vowel production : eat: it, at

Syllable structure errors Cluster reduction: tuck: stuck, truck, cluck Word-initial deletion: eat: Pete, feet, wheat, meat Word- final deletion: bee: beat, beef, bees, beach

Time frame: 30 to 45 minutes twice a week for a minimum of 21 weeks.

Multiple oppositionsIntervention works for Bootstrap because:He fit the age recommendation.He struggles with multiple sound errorsIt has shown to be effective for children with

a moderate to profound phonological disorderIs thought to decrease the amount of time a

child a child needs treatment.

Plan of ActionGoals:

Increase expressive language by producing one word utterances by targeting FCD

Reduce production of Gliding

Plan of Action Cont’dObjectives:

Bootstrap will duplicate one word utterances 4 out of 5 attempts over 3 consecutive sessions

He will instinctively produce one word utterances 3 out of 5 attempts over 3 sessions

Bootstrap will both imitate and spontaneously include deleted sounds in final word positions 3 out 5 attempts

He will imitate and spontaneously reduce production of gliding

Referenceshttps://health.google.com/health/ref/

Phonological+disorderhttp://www.minddisorders.com/Ob-Ps/

Phonological-disorder.htmlhttp://www.iu.edu/~srlweb/pr/25/bergeson-

245.pdf

THE END