Makenzie Cockerill Observation

Summary of Interpretation: Given the information provided in Interpretation A, the clinician diagnosed Kara-Lynn with a severe phonological disorder. This diagnosis was made based on evidence provided by testing results, clinician observations, and speech analyses. Kara-Lynn demonstrated phoneme collapses into /d/ in place of stops (/p/, /t/, /k/, /g/), fricatives (/s/, /z/, /θ/, /ð/), and some consonant clusters (/tr/, /gr/) across all word positions. For example, Kara-Lynn produced /diə/ for “seal,” /dædɚ/ for “treasure,” and /dədudɚ/ for “computer.” Kara-Lynn also presented with active phonological processes of final consonant deletion (/fɪ/ for “fish”), cluster reduction (/tul/ for “school”), vocalization (/ɛləkə/ for “helicopter”), and deaffrication (/ʃi/ for “cheese”). She also presented with inconsistent patterns of initial-consonant deletion (/ɑʊps/ for “house”, /ɪʒ/ for “bridge”). In most instances, Kara-Lynn presented with both final consonant deletion and another phonological process, which markedly impacted her speech intelligibility, as when she produced /lɑʊ/ for “clown,” demonstrating both final consonant deletion and cluster reduction. She also expressed a high percentage of CV (27%) and CVC (29%) syllable and word shapes, with little other variation. Analysis of Kara-Lynn’s speech sample revealed similar errors exhibited during formal assessment, including phoneme collapse into /d/, high occurrences of initial and final consonant deletion and cluster

I feel that the communicating between Patient A and myself worked well during this event. I noticed that she was uncomfortable by her body language and I picked up quickly which method was best to

On Friday, March 31st I observed Northside Elementary School in the Brookville school district. I watched in a separate speech therapy classroom for students who also require special education. There was only one student who attended each session and the only professional in the classroom was the speech language pathologist, Miss. Haag.

The opportunity to observe the work overview of a Speech Pathologist, has tremendously solidified my interest in this field. At the Diana Rogovin Speech Center at Brooklyn College, I observed clients of various ages with different speech language disorders including articulation, language, voice, fluency and accent modification. Observing clinicians at the speech center gave me the opportunity to learn how important client-clinician interaction is for the session and how essential it is to build a good relationship with the client. Although I learned the

Preschoolers with verbalization sound disorders have clinically consequential impairments in the engenderment of sound production of the ambient language. Although many of these produced sound errors resolve after several years (with or sometimes without intervention), developmental appropriate speech sound production is not always achieved. Some sound errors may continue into adulthood. Concretely, (Preston, Hull, & Edwards, 2013) intended to determine if preschool verbalization error types (e.g., atypical sound errors and distortion errors), which may reflect different levels of psycholinguistic processing, are indicative of school-age phonological awareness and verbalization sound outcomes.

Ava Bracciante, an eight year-one month old female, who has been attending Lehman College Speech and Hearing Clinic since spring 2014 due to parental concerns regarding her articulation. She is currently attending the clinic once a week for 50-minute sessions. Ava’s parents, Mr. and Mrs. Bracciante, provided the case history report and stated that Ava received a speech-language evaluation at the Ampark School in 2014. The evaluation revealed gliding of the lingua-palatal rhotic /r/ and vocalization of the rhotic diphthong /ɚ/; her intelligibility was not compromised; therefore, she did not qualify for services. Mrs. Bracciante reported that she has seen an improvement in Ava’s speech and is an active participant to her progress.

Kara-lynn is a 3 year; 6 month old female presenting with a severe phonological disorder. Her results from testing indicate that her speech intelligibility is significantly reduced due to multiple phoneme collapses into /d/ of the following phonemes and consonant clusters: /p/, /g/, /k/, /s/, /z/, /θ/, /ð/, /tr/,and /gr/. In addition, the use of multiple phonological processes, including: final consonant deletion, initial consonant deletion, cluster reduction, vocalization, and deaffrication also significantly contribute to her reduced intelligibility. Her speech intelligibility in known context was calculated to be 64%, which is low for a child who is 3 years; 6 months(consider adding reference). Reduced intelligibility can impact a child’s ability to communicate wants and needs, making Kara-Lynn’s speech intelligibility an area of need.

From being diagnosed at a young age with dyslexia and apraxia of the speech, I am not sure where I would be without the help and encouragement of my speech pathologists. ‘Speech-language pathologists assess, diagnose, treat, and help to prevent communication and swallowing disorders in patients’ (Summary, www.bls.org, 2015). Along with helping their patients overcome or learn how to understand their disorders, speech pathologists must keep records.

The scope of practice of speech-language pathology describes the ethical and clinical responsibility of clinicians to implement therapy techniques, which contains efficacy that is supported by evidence. Non-speech oral-motor exercises (NSOMEs), in particular have raised controversy among speech-language pathologists (SLPs) and researchers when treating children with articulation and phonological disorders. The use of NSOMEs is a debated issue in the profession due to the lack of evidence based practice (EBP), poor clinical assumptions, and the avoidance of meeting the client’s needs.

The purpose of this evidence based research paper is to evaluate the efficacy of the cycles approach when compared to the traditional articulation therapy approach in the treatment of children who are highly unintelligible. The Cycles Phonological Remediation Approach (Hodson, 2011) is a treatment method for children with severe speech sound disorders. This approach targets phonological pattern errors in a sequential manner. During each cycle, one or more phonological patterns are targeted and after each cycle is complete, another cycle begins. Recycling of phonological patterns continues until the targeted patterns are generalized into the child’s conversational speech. The cycles approach is meant to mirror typical phonological development in children (Hodson, 2011).

Those students are always in for a long road of speech therapy as well as, problems with reading. I am interested in new research in the area because these students are typically of average intelligence but struggle in school immensely because of their disorder. According to the webinar on Childhood Apraxia of Speech, CAS is defined as a neurological childhood speech sound disorder in which the precision and consistency of movements underlying speech are impaired. The main features of the disorder consist of inconsistent errors lengthened, disrupted coarticulatory transitions, and inappropriate prosody. Motor performance is the generalization of learned behaviors while motor learning is the retention or generalization of learned behaviors. Motor learning is the problem that children with CAS encounter. Phonological awareness is important for students with CAS because they have difficulty with reading and spelling. The training of sounds can be done while also training speech sound production. A new therapy technique for CAS is using ultrasound biofeedback to establish a motor skill at the syllable or word level. The benefits of ultrasound are that the student can visually see the elevation of the tongue or retraction on hard to form sounds such as /r/. The disadvantage is that most clinicians do not have access to ultrasound at a reasonable cost to

A speech language pathologist, otherwise known as an SLP, deals with many people throughout their career, which includes patients who do and do not want to receive assistance for their disorders. Sometimes a patient might refuse because they are too young to understand why they need therapy, and adults might refuse the aid of an SLP because they do not find it necessary to receive treatment for the speech, language, or hearing disorder. To address these problems SLP’s will have to give the proper help to the patient as needed. For a child, the SLP might use toys or activities to get the child involved in a talking atmosphere. In a adult’s case, it would be ideal to give the patient as much information as possible in order to let them fully

With a very young child, they may not coo or babble during infancy, produce first words late and lack some sounds, only produce a few different consonant and vowel sounds, have difficulty combining sounds, avoid using difficult sounds by replacing or deleting them, and experience eating problems. In older children, common signs are that they can comprehend language much easier than they can produce it, struggle more with language production when anxious, are hard to understand, sound choppy and monotonous, seem to grope to produce certain sounds, and have difficulty imitating speech, though they are more fluid and clear with imitation than with spontaneous production. At any age, a child may portray delayed language development, issues with expressive language, fine motor impairments, hypersensitivity, hyposensitivity, and difficulty learning to write (“Childhood Apraxia,” 2011). Other reported possible symptoms of CAS include extended reliance on nonverbal communication and omission of consonant sounds in the initial and final positions of words (“Apraxia: Symptoms, Causes,” n.d.).

Clinical Implications: Minimal-contrast treatment is effective and efficient for treating children with phonological disability. Avoiding listener confusion is motivating for suppressing process use.

“Phonological disorders in children can result from physical or organic causes or may be functional in nature ("Phonological disorders in," 2013)”. Children with a phonological disorder may experience a higher risk for reading and writing disabilities. “If left unresolved, phonological disorders have long-term consequences that may interfere with an individual's future social, academic, and vocational well-being, largely resulting from persistent, reduced intelligibility of speech ("Phonological disorders in," 2013).”