The Ethical and Clinical Responsibilities of Speech-Language Pathologists

Based on the outcome assessments the speech therapist may find alternatives to increase treatment outcomes.

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

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.

Outcomes of taught target sounds can generalize to other sounds and contexts if the clinician provides the client with adequate training and opportunities, compared to assuming that acquisition in one setting will automatically generalize (McReynolds, 1989). Clinicians must plan for generalization before the start of treatment (Kearns, 1989). Factors for generalization can include: treatment approach and target phonemes. In order for the client to generalize the treatment, therefore showing true success, the client needs an effective treatment approach. Although not one

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).

The first article, The efficacy of the cycles approach: A multiple baseline design explored three participants from age 4:3 to 5:3 using the cycles approach in cycles of therapy. The cycles approach uses pattern based targets. This could be difficult to implement for Jacob. Jacob does not say any intelligible words consistently. However, the second key component described in this of targeting problematic patterns in a cycles approach without the criteria of meeting proficiency. This study would apply to Jacob’s treatment. Participants in this study exhibited Speech Sound Disorders that greatly influenced their intelligibility. Two out of three participants in the study made rapid improvement. Due to Jacob’s low intelligibility, this method would be beneficial for his improvement.

The speech therapist work with children one-to-one and go to a place where the children feel more comfortable – which is usually their home or daycare. There are a variety of language activities that the speech therapist does to improve children’s speech. Although each child may be different, many sessions will usually begin with the speech therapist simply just having conversations with the children to help develop their talking and understanding of what other people say. The therapist will also demonstrate sounds by physically showing the children how to move their tongues. Another exercise the speech therapist may use is teaching children different exercises to increase the strength of their muscles in their mouths, tongues, and jaws. Midlands Therapy Services believes that all those exercises are very important in receiving quality results from the child; however, they also believe that family plays a big role also. They believe that it is important that parents demonstrate correct speech and language practices with their children also to help achieve their goals. Children achieving their goals are significantly important and in order for children to do that they must complete the exercises given by therapists to the best of their ability; however, that can become

I plan on pursuing a career as a speech-language pathologist (SLP). As a speech language pathologist, I would be assessing, diagnosing, treating, and helping to prevent communication and swallowing disorders in patients. As a result for my passion to work with children, I became highly interested in psychology and child advocacy. I believe all three fields are interrelated because they share a common interest to understand the basic needs of a child. In addition, these fields help assess the influence of family and other social contexts on children’s’ socio-emotional adjustment, cognitive development, behavioral adaptation and health status. One of the reasons, I decided to pursue a career involving advocating for children, is because children always fascinated me. One of my inspirations is my younger cousin who suffers from hypotonia, which is a poor-muscle tone disorder. Therefore, it affects muscle strength, motor nerves and the brain. As he got older, he needed a SLP to help with the muscles associated with articulation. Before then, I didn’t know much about speech pathology, but I can appreciate the career because I saw how speech therapy helped my cousin. In a professional experience, I am currently volunteering in the Alder Aphasia center in West Orange, helping individuals with aphasia, practice speech therapy. As a result for volunteering, I plan to become a member of the NJ SHA multicultural committee advocating for children and

On March 7, 2016, I observed Makenzie Cockerill in room A117 from 10:00-10:45 am. The client was preschool-aged. The clinician informed me that the client had low intelligibility. The objectives of the day were to work on the /b/ sounds and beginning vowel sounds. The clinician also planned to do a mini screening of Child Apraxia of Speech. However, she informed me that she didn’t believe that this was the case in the child, but they wanted to rule it out. The client had multiple speech sounds in error, so the clinician implemented a cyclical strategy.

Child hood Apraxia of Speech is a motor speech disorder that affects children’s ability to say sounds, syllables, and words. The brain has trouble coordinating muscle movements that are needed for speech. The child knows exactly what to speak, but the brain has trouble coordinating the muscle movements. It is different for every person that has this type of disorder. In some other cases, it can be an unknown cause, meaning it can happen out of the blue, or by mutations. One of the articles is based off of reliability and validity testing and scoring by the Dynamic Evaluation of Motor Speech Skills, while the other has different assessments that were tested and transcribed.

Formal and informal assessment tools were used during this evaluation to determine the client’s speech and language skills. After a thorough evaluation, this clinician deems it appropriate for therapeutic programing to target the following: (1) improving N’s expressive language skills, specifically his use of age-appropriate morphosyntactic markers and high-frequency vocabulary; (2) expanding the length of N’s utterances from 2-word utterances to 3-5 word utterances; (3) improving N’s comprehension of language for high frequency concepts, including understanding of quantitative and spatial concepts and Wh- questions.

If my partner was an actual client, I would not recommend treatment based on her formal articulation assessment performance from the Arizona Articulation Proficiency Scale, Third Revision. The client’s hypothetical age was 3 years, 10 months, and 27 days old. This put her in the 3-11 age category. Although, my partner did produce some errors. She was intelligible, and scored 85.0 to 94 on the speech intelligibility interpretation values. According to her Arizona-3 total score, her level of articulatory impairment was within normal limits. The errors she produced consisted of instances of /f/ for / θ/, velar fronting with /k/ for /t/, gliding, and depalatization. She produced /tw/ for /tr/, /pw/ for /pl/, /w/ for /l/, /w/ for /r/, and /gw/ for

In a document entitled “Scope of Practice in Speech-Language Pathology”, the professionals at the American Speech and Hearing Association (ASHA) thoroughly explain the profession of speech language pathology and the extent of practice within speech-language pathology. The article includes the following information: purpose statement of the article, definition of speech-language pathologists and speech-language pathology, objectives of speech-language pathology, and the practice and delivery domains. Information from each section is summarized below.

A structured, play-based approach therapy was used throughout this semester. Therapy was conducted on Monday and Wednesdays for 30-minute sessions. Therapy sessions were broken up into four different activities or more that provided many opportunities for XX to produce verbal “yes” and production of the targeted phonemes. XX independently answered with "ya" but when the clinician modeled "yes" he would repeat "yes" with the correct production of "yes" including a final /s/ in the word. All activities were strategically planned to capture his interest and attention so he would not become frustrated and lose motivation. An example of therapy that XX enjoyed was the articulation fishing game where the clinicians would tape different phoneme photos on the back of a fish for him to produce once a fish was caught. Clinicians founds success in therapy games when turn taking and withholding objects were put into place. Due to XX’s attention span and energy, it was best if one of the activities included a movement activity to get him moving instead of sitting for the remainder of therapy. Clinicians consistently used verbal reinforcement after every correct production. A visual schedule was also incorporated for XX to stay focused followed by putting a

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