HISTORICAL PERSPECTIVE The Evolution of Current Practices.
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Transcript of HISTORICAL PERSPECTIVE The Evolution of Current Practices.
HISTORICAL PERSPECTIVE
The Evolution of Current Practices
Articulation Sound-by-Sound Approach
(Assessment-Target Selection-Intervention)
SPEECH DISORDERS
Historical Perspective: Historical Perspective: The Way We Were to Where We AreThe Way We Were to Where We Are
(1920’s – 1970’s)
Historical Perspective of Speech Disorders in Children
• 1960’s: Sound-by-Sound Analysis– motor problem -> intervention focused on
positioning/movement of articulators– sound-by-sound approach assessment/intervention
• 1970’s: Pattern Analyses– relationship among errors (distinctive features, PVM)– 1976: Ingram’s “Phonological Disability in Children”
1970’s – 1990’s Artic-Phonology Tree
ArticPhonology Ingram (1976)Phonological Processes
Linguistically based
Focus shifted from “mouth” to “mind”
Began to treat younger children who had more severe unintelligible speech
Order in the disorder
Shift in analysis (patterns) and intervention (generalization)
SPEECH DISORDERS
Historical Perspective (continued)
• 1980’s: Phonological Process Analysis– “Individual Differences”– Competence + Performance = Knowledge (PPK)– PPK --> treatment implications (predictions)
• 1990’s: Independent “Self-Contained” Sound Systems– treatment efficacy (variations in intervention models)– unique language systems
2010 MP
MO
MaxO
ES
MP
A
CVP
LA
STIM
PACT
Cycles
MPPA
NSIT
NLP
A
NN
INTERVENTION
PhonemicApproaches Phonetic
Approaches
PR
OM
PT
Nuffield
DT
TC
ASSESSMENT
TARGET
PhonologicalComplexity
Distance Metric(Systemic Approach)
Independent + Relational
Later sounds N
on-stimulable Markedness
Artic
PPK
PVMPPA
Optimality Theory
Con
stra
int B
ased
Early sounds
Stim
ulable
Maxim
al
Distinction
Maximal
Classification
SELECTION
SPACS
Differential Diagnosis of SSD(Diagnostic Subgroups)(cf Shriberg, 1994; Dodd, 1995)
Relational
Non-lin
ear
Lin
ear
Traditional
2000 to Today
• Learnability theory – the structure of languages that makes them “learnable”
• Teachability – the structure of input that maximizes learnability
• Evidence-Based Practice (and Practice-Based Evidence)
• International Classification of Functioning, Disability, and Health (ICF-CY; World Health Organization)
Historical and Theoretical Perspective Links
Analysis
Target Selection
Intervention
Differential Diagnosis of SSD(Shriberg, 1994; Dodd, 1995)
Complexity of Theories(Assessment, Target Selection, Intervention)
Linear(1920’s – 1970’s)
(1970’s – 1990’s)
(2011)
Traditional Perspective: Linear
10% 5%
85%
20% 10%
70%
Systemic Perspective: It’s About Time
CHILDCHILDDISCHARGDISCHARGEDED2-3 YEARS2-3 YEARS
CHILDCHILDDISCHARGDISCHARGEDED2-3 YEARS2-3 YEARS
2-3 YEARS REMAINING FOR INTERVENTION
CHILDCHILDDISCHARGDISCHARGEDED2-3 YEARS2-3 YEARS
CHILDCHILDDISCHARGDISCHARGEDED2-3 YEARS2-3 YEARS
Classification of SSD
Etiological Classification
vs
Linguistic Profiling
Etiological Classification (Shriberg, 1997; 2006)SSD Subtypes Prevalence Probable Etiology Affected Process
Speech Delay-Gen (SD-GEN)
56% Polygenic/Environmental Cognitive-Linguistic
Speech Delay-Otitis media with effusion (SD-OME)
30% Polygenic/Environmental Auditory-Perceptual
Speech Delay-Developmental Psychosocial Involvement (SD-DPI)
12% Polygenic/Environmental Affective-Temperamental(shy)
Speech Delay-Apraxia of Speech (SD-AOS)
<1% Monogenic? Oligogenic? Speech-Motor Control
Speech Delay-Dysarthria (SD-DYS)
<2% of SD population
Monogenic? Oligogenic? Speech-Motor Control
Speech Errors-Sibilants (SE-/s/)
Environmental Phonological Atunement
Speech Errors-Rhotics (SE-/r/)
Environmental Phonological Atunement
Linguistic Profiling (Dodd, 1995; 2005)
Linguistic Profile Characteristics
Phonological Delay (gliding, fronting, stopping) Phonological rules or processes are evident and are characteristic of younger TD children
Consistent Deviant Phonological Disorder(Not typical sound errers. A mix of of unusal patterns)(CONSISTANT)
Presence of both unusual errors and typical errors, which signal the child has impaired understanding of the ambient phonological system
Inconsistent Deviant Phonological Disorder(Word inconsistancy-say the word shoe different ways – sue,shue sew)
Exhibit delayed and non-developmental error types and variability of production of single word tokens (> 40%)
Articulation Disorder Unable to produce particular perceptually acceptable phones
Childhood Apraxia of Speech (CAS) Deviant surface speech production patterns that may sound similar to Incon Dev Phono Dis, but difference is the proposed level of breakdown and symptomatology