Strategies to Increase Students’ Success in Therapy and Beyond

Speech-language pathologists have a significant role in children’s communication success, learning and development. We are skilled at evaluating students with learning challenges and identifying those with communication disorders. We have the responsibility to provide speech-language therapy services using research based strategies and techniques to improve the communication and language abilities of children and adolescents. It is critical that we remain knowledgeable of these strategies as we provide speech-language therapy services. The therapy approaches and strategies used by speech-language pathologists will vary to some degree based on the disorder that they are treating and the severity. Here are strategies that SLPs can use to increase students’ success in therapy and beyond. Children and adolescents will learn to use many of these strategies as well during guided and independent practice so they can be independent communicators and life long learners.

ARTICULATION/PHONOLOGY

1. Auditory Bombardment (Wolfe, Presley, & Mesaris, 2003)

The speech-language pathologist exposes a child to the correct speech production of target phonemes during child centered activities. For example, the SLP may read aloud a story and emphasize words with the speech sound that the child needs to learn how to pronounce correctly. The SLP may read a list of words containing the target sounds. This will help kids enhance their phonological or sound awareness, rate of sound development, and generalization over time in their verbal communication. This is a component of speech sound perception training.

2. Auditory Discrimination Practice (Baker, 2010)

Children with articulation and phonological disorders need to be able to hear the distinct differences between phonemes. They can practice this skill during minimal pair drills that require them to identify and say words that vary by one sound.

3. Cycles Approach Practice  (Hodson, 2010)

Children with phonological disorders and highly unintelligible speech benefit from the Cycles Phonological Pattern Approach that targets patterns of speech sound errors. During each therapy session, the SLP targets one or more phonological pattern error to improve speech intelligibility.

4. Phonetic placement and shaping/Gestural Cueing (e.g., Preston, Brick, & Landi, 2013)

The SLP teaches kids where to place their speech articulators to pronounce certain sounds. They can use physical prompts to help show them how to move their lips, tongue, or jaw to pronounce specific sounds that they are having difficulty pronouncing. In gestural cueing, the SLP demonstrates a motion or gesture to help the child visualize and remember the place or manner of production. This is used frequently in programs such as Lindamood Phoneme Sequencing Program (LIPS). Tactile cues such as PROMPT© (Prompts for Restructuring Oral Muscular Phonetic Targets) is a  treatment method derived from touch pressure, kinesthetic, and proprioceptive cues (Hayden, Eigen, Walker, & Olsen, 2010).

After children learn the phonetic placement of the sound, the SLP provides practice for them to work on improving their speech articulation skills in a hierarchy moving from isolation, syllables, words, sentences, to conversation.

RECEPTIVE/EXPRESSIVE LANGUAGE

5. Verbal modeling and guided practice

In order to learn new skills, it is critical that children are first taught the skill and then provided several opportunities to practice. For example, if you want the child to learn how to explain similarities and differences, a speech-language pathologist must teach what each word means and then demonstrate the skill. During guided and independent practice, the speech-language pathologist should provide feedback about how the child is doing.

6. Visual supports

Most children with language disorders learn best when provided with visual aids. This may be a graphic organizer to help them remember and retell story elements or other visuals to help them remember how to complete semantic and syntax practice exercises. Children can also create their own visuals to illustrate vocabulary or content that they are learning in speech-language therapy and the classroom.

7. Direct vocabulary instruction (Marzano, 2004)

Children need repeated exposures of vocabulary words to truly comprehend them and to accurately use the words in their spoken and written language. Direct vocabulary instruction will increase their background knowledge, comprehension, and overall academic success.

8. Verbal prompts and cues

Speech-language pathologists provide students with verbal prompts and cues to support them in correctly answering questions related to their area of language need. This type of language scaffolding provides a bridge for students to link what they already know to new skills and content that they are learning. By providing verbal prompts and cues during a mini-lesson, the SLP scaffolds or breaks down the instruction in a manner that enables the student to learn a new skill and information. Other language scaffolding involves simplifying verbal directions. Prompts, cues, and language scaffolding should be faded over time.

9. Expansions

The SLP may expand or lengthen  a child’s speech utterance to model additional vocabulary or a more complex syntax or sentence structure.

10. Recasts

The SLP modifies a child’s speech utterance by changing the type of sentence or voice. If a child says a statement, the SLP may recast or change it into an interrogative sentence. The SLP may also provide a verbal model by changing a sentence from active to passive voice to show variance of sentence styles.

11. Predictions/Inferences

The SLP may teach students how to make predictions or inferences based on illustrations in a book or the content of the fiction or non-fiction text. The SLP can help students connect what they already know (background knowledge) to deduce what will happen next or infer meanings of unknown words in language and literacy lessons.

12. Mental Imagery

Students practice visualizing what they hear or read to aid comprehension of information. SLPs can teach  students to make a movie in their head so a story or topic comes alive or becomes more relatable.

13.  Summarizing

The SLP can demonstrate how to summarize fiction or non-fiction information. Students can verbalize or write brief information highlighting the sequence of events or key points about what they hear or read.

14.  Questioning

Students learn how to ask questions to ensure they are understanding what they hear or learn. They can write questions on reading passages to extend learning or seek clarification of information.

15. Think Alouds/Problem Solving

The SLP should demonstrate for students how to think critically during language and literacy activities. While reading a book, he or she should pause and model asking questions and making comments about what is going on. The SLP should provide multiple opportunities for children in speech-language sessions to answer critical thinking and inferential questions during a variety of age appropriate tasks.

FLUENCY

16.  Speech modification/Fluency Shaping (Guitar, 2013)

These are strategies include pausing, easy onset, rate control, light articulatory contact, continuous phonation, and prolonged syllables.

17.  Stuttering modification (Van Riper, 1973)

A child or adolescent will need to learn to recognize the moments of dysfluency by anticipating the non-fluent speech before it occurs, during a stutter, and after dysfluent speech. They will learn to use preparatory set, pull-out, or cancellation stuttering modification strategies to improve their speech fluency.

18 . Desensitization

This involves changing the student’s fear or apprehension about speaking in a variety of speaking situations. In speech therapy, the SLP can demonstrate pseudostuttering in a social scenario in which the client may stutter a lot such as talking on the phone or during a class presentation. The student should also practice this fake or voluntary stuttering as a part of his or her therapy regimen.

19. Cognitive Restructuring (Murphy 2007)

This involves the SLP teaching a student how to think about his or her feelings when they stutter. Any negative feelings must be addressed to reframe a child’s mindset about being a person who stutters. It is critical that the SLP address the emotional contributing factors to stuttering in order to effectively reduce stuttering episodes.

20. Generalization Activities

The SLP should provide opportunities for children and adolescents to practice fluency shaping and stuttering modification strategies outside of the therapy room.  She or he could provide fluency strategy cards to use in the general education classroom. The SLP can help monitor the client’s communication in different settings and activities at school such as when checking out books in the library, talking with classmates, or giving a presentation in class.

In addition to these strategies, there are systematic therapeutic programs that SLPs can use to improve the speech-language skills of children and adolescents. However, the programs and techniques implemented will vary based on the clinical decisions of the therapist.

There are more approaches and strategies for students’ success available via ASHA’s Practice Portal for speech-language pathologists. This is an extensive resource that will ensure that SLPs have access to evidence for remediating communication disorders and improving their therapeutic efficiency. http://www.asha.org/practice-portal/

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