The Power of Building Vocabulary Through Context

What is critical for children’s and adolescents’ communication, language, and literacy success? There are so many contributing factors, but vocabulary development is most definitely critical. Speech-language pathologists need to focus on building vocabulary skills of children and adolescents when providing speech-language therapy each week to those with communication and language disorders.

Children’s exposure to vocabulary varies based on how language rich their home, school, and community environments are in providing language stimulation. The playing field is not the same. Vocabulary knowledge and use is directly linked to economic status of families. The National Center for Education statistics reports that by the time a child in the U.S. reaches 3 years of age, there is a 30 million word gap between children of wealthy vs. poor families. Similarly, 34 % of kindergarten children in the U.S. lack the basic language skills that are necessary to become effective readers and learners.

This is why it’s so important for speech-language pathologists to provide intervention to build vocabulary skills. This is a powerful way to deliver positive and visible results in children’s communication, language, and literacy skills. There are so many words that children need to learn. How can you as the SLP provide therapeutic intervention in a way for them to understand and practice new words? You need to provide multiple exposures of the word in context of hands on activities, sentence context, and paragraph context. Children and adolescents will learn new words when they can hear the word, see the word, say the word, act it out, read the word, and write the word. Here are 4 activities to harness the power of building vocabulary through context.

1) Emphasize new words during play activities.

For younger kids this will help them build nouns, verbs, and adjectives. Use seasonal activities to build everyday tier 1 vocabulary for early language learners with speech-language impairment. Fall is a great time to bring objects into the speech room. Kids can name the items such as apples, pumpkins, stem, leaves, seeds, vine, and squash. They can describe the objects using adjectives such as red, green, orange, yellow, white, big, little, smooth, bumpy, sweet, sour, slimy, wet. Provide visuals for kids to label/match the nouns, verbs, and adjectives with the appropriate item. The SLP can provide a verbal model for simple sentences. Then kids can say and write their own sentences with key vocabulary such as: I like the green apple, It tastes sour, The inside of the pumpkin is slimy, or The pumpkin seed is little.

2) Use task cards to build tier 2 vocabulary using sentence & paragraph context.

I suggest using my Fall Multiple Meanings task cards with upper elementary and middle school students. The SLP or students can read aloud the sentences and then the children have to select the correct meaning of the homograph from a choice of 4 answers. They can use a dry erase marker to select their answer on laminated cards. This activity works well during group speech-language therapy sessions. These task cards are a part of my differentiated Fall Themed Multiple Meanings activity packet.

3) Use children’s literature to build tier 2 vocabulary using sentence & paragraph context.

I recommend that the SLP preselect tier 2 vocabulary from fiction text. Use your favorite seasonal or year round books to introduce more challenging vocabulary to children and adolescents. Read aloud the story and teach them how to use context clues or helpful hints in the sentence or paragraph to predict the meaning of the unfamiliar word. As extension activities across multiple sessions, you can integrate Marzano’s 6 vocabulary building steps discussed in my last blog post with the new vocabulary from the fiction book. Subscribe to my blog/upcoming newsletter to get a related worksheet for children to use as they learn new words in children’s literature.

4) Use high interest non-fiction and diverse text with key tier 2 vocabulary targets.

Select topics of interest for children on your caseload. Give them excerpts of text and have them highlight or underline challenging vocabulary. Guide them through using context clues strategies to identify the meaning of the unfamiliar word.  Again, use Marzano’s research based & proven six steps of vocabulary building to further reinforce and provide multiple exposures of tier 2 words. Remember as an SLP, your job is to maintain the therapeutic focus of the lesson by modeling the strategy that needs to be implemented and providing opportunities for children to practice.

Speech-language pathologists will remediate receptive and expressive language disorders in children and adolescents when they use the power of building vocabulary in context. Build vocabulary using context from hands on activities, sentence context, and paragraph context. Remember children need repetition and multiple exposures of a word to truly build receptive and expressive vocabulary skills in a meaningful manner. Make sure that you integrate this significant intervention method so children can build speech-language skills. Overtime, this will contribute to closing the achievement gap for children with communication and language disorders.

 

 

Six Vocabulary Building Steps for Speech-Language Therapy

Vocabulary knowledge and expression is critical for children and adolescents’ success in communicating their ideas and summarizing curriculum information. But what about those with communication disorders, language disorders, and learning disabilities? They often have a limited vocabulary that hinders their ability to comprehend information and clearly express their thoughts. They need direct instruction from speech language pathologists to learn vocabulary building strategies. They need multiple exposures of a word to transfer it to their spoken vocabulary. They need opportunities to hear new words, speak them, read them, and write them in the appropriate context. Children and adolescents need to be taught high frequency tier 2 vocabulary words. However, young children also need therapeutic intervention to expand their semantic processing skills of Tier 1 everyday vocabulary. Did you know that there are six vocabulary building research based steps that speech-language pathologists can use during intervention? Yep. You may have activities that have words that you want to teach, but how do you go about it?

Where do you begin? First, you need assessments to determine where to start in speech language therapy sessions. I’ve got you covered as my Vocabulary Progress Monitoring tool directly addresses semantic processing skills. With information from these informal assessments you can effectively determine starting points in therapy and quickly determine growth over time. There is a hierarchy of progression  for semantic processing of tier 1 vocabulary words and then kids move on to learning tier 2 words. Children typically learn to label, state functions, name word associations, convergent/divergent categories, explain similarities/differences of basic words, state antonyms, state synonyms and explain multiple meanings words (tier 2). I do not suggest teaching the words in the vocabulary progress monitoring tool, but you can determine where in the semantic/neurological hierarchy to target in therapy.

A metaanalysis of research studies confirmed that identifying similarities and differences had a 45 percentile gain in overall student achievement (Marzano 2001).

When children start kindergarten, they have varying levels of vocabulary knowledge and expression based on previous language exposure at home, preschool, and in their community. Speech-language pathologists may remind classroom teachers that they need to explicitly teach word building strategies to children. Teachers can use the Vocabulary Progress Monitoring tool for students in the Response to Intervention (RTI) process to evaluate what they know and monitor their progress after provided direct instruction.

Over the years, I have seen significant progress in children’s and adolescents’ communication and language skills when they are directly taught vocabulary and provided opportunities to learn and use new words.

In order to effectively instruct students during speech-language therapy, you must clearly understand the three tiers of vocabulary before you can implement the 6 vocabulary building steps.

Tier 1 words are high frequency vocabulary that are often heard everyday in conversation and learned by many children during incidental learning. These are basic level words. However, many young children with language disorders have a limited repertoire of these words and require direct instruction of these words.

Tier 2 words are high frequency  and general academic vocabulary that are used across content areas. These include words such as analyze, compare, contrast, and multiple meaning words.

Tier 3 words are considered low frequency vocabulary because they are specific to curriculum subject matter such as social studies or science. These may be words such as topography, ecosystem, or molecule.

Speech-language pathologists should primarily focus on building Tier 1 and Tier 2 vocabulary skills for children and adolescents with language disorders because these are frequently occurring words in conversation and academic curriculum. So, what are the six vocabulary building strategies that SLPs may use in speech-language therapy? These are based on educational expert, Dr. Robert Marzano’s research over the years.

1. SLP describes a new word and provides an example.

This goes beyond saying the definition.

2. Child restates or describes the new term in his or her own words.

3. Child creates a non-linguistic representation of the word such as a drawing or acting out the word.

A metaanalysis of research studies confirm that non-linguistic representations led to a 27 percentile gain in overall student achievement (Marzano 2001).

4. Child completes an interactive activity to extend his or her understanding of the new word.

5. Child verbally discusses new vocabulary term with others.

He or she needs time for oral language practice. This is critical to deepening understanding of the word.

6. Child plays learning games to review new vocabulary.

I know that speech-language therapists provide countless descriptions of new words with visuals for children and adolescents during language therapy. Students complete many activities including word descriptions and play vocabulary learning games in therapy session. Nevertheless, it is important to keep in mind these 6 research based steps for vocabulary building. Dr. Robert Marzano’s research points out that it is important not to skip steps. Therefore, in clinical practice for SLPs, perhaps we should think about how many of these steps we are doing. Do our sessions have a emphasis at times on playing games in language therapy? Yes, it’s fun, but we must take the time to directly teach new vocabulary and not just jump to the activity or game. However, I do acknowledge that games such as Blurt do provide opportunities for the SLP and children to describe new words while participating in an interactive game. It is often in these opportunities that children can practice listening to descriptions, building word retrieval skills, and confirming their learning of new words. However, SLPs should try to implement the Six Steps for Building Vocabulary in their speech-language therapy sessions with children and adolescents. I acknowledge that SLPs have a limited time each speech language therapy session. Therefore, you most likely can not implement all 6 steps in 1 session. However, I encourage you to reflect on the suggested progression of steps proposed by Dr. Marzano and see if there are adjustments that you may make in your clinical practice to promote children’s semantic growth. As speech language pathologists, we are therapeutic specialists who can break down learning and give children multiple exposures to acquire new words both receptively and expressively.

Remember that “student’s vocabulary knowledge is directly tied to their success in school” (Marzano 2013).

References:

2013. Marzano, R., Simms, J. Vocabulary for the Common Core. Bloomington, IN: Marzano Research.

2004. Marzano, R., Building Background Knowledge for Academic Achievement. Research on What Works in Schools. Alexandria, VA: ASCD.

2001. Marzano, R., Pickering, D., Pollock, J. Classroom Instruction that Works. Research-Based Strategies for Increasing Student Achievement. Alexandria, VA: ASCD.

2007. Richard, G., Hanner, M. Language Processing Treatment Activities. LinguiSystems Inc. Austin, TX.

Do you want to read more articles about direct vocabulary instruction? Check out these previous posts on my blog.

Why Teach Word Associations?

Why Do You Teach Categorization in Speech-Language Therapy?

Why Teach Multiple Meaning Words?

Do you need activities to work on vocabulary building in speech-language therapy? I have several therapy activities for SLPs to use with children and adolescents available for digital download in my TPT store. You can also click on the vocabulary activities section  under TOPICS on this blog. Just scroll back to the top to read more.

SLP Professional Growth with Intervention Programs Implementation and Certifications {Evidence-Based}

Enhancing the Delivery of Quality Speech & Language Services and Children’s Progress in Therapy

Lately I’ve been thinking about ways that speech-language pathologists can continue to grow professionally. In our field it is critical to stay current with best practices in assessment and therapy services.  It’s important that we know how best to remediate articulation, phonology, motor speech,  feeding, speech fluency and language disorders. We need to be able to use therapeutic strategies and approaches to remediate these communication and feeding/swallowing disorders. We need to know about available speech-language  interventions/curriculum programs and certifications that can help improve the quality of our service delivery. We also need to be aware of allied health therapy programs that may enhance the success of our clients as well. Some of these programs and interventions are supported by evidence-based research while others do not currently have evidence to support the validity  of a proposed therapeutic approach to improve the communication, language, and literacy skills of children and adolescents. Therefore, it is important that speech-language pathologists are aware of the pros and cons of the available therapeutic programs and certifications.

Additionally, the methods of service delivery may change based on the  job setting of a pediatric speech-language pathologist and if the SLP is providing individual vs. group therapy.  Is it possible to enhance the delivery of quality speech & language services in both individual and group speech language therapy sessions?  Can children and adolescents make progress on their speech/language skills in both types of therapeutic sessions? Over the years, I’ve worked in settings where I’ve had time to focus more on individualizing therapy sessions versus group pediatric therapy sessions. In some instances, I have been able to provide education and coaching for parents and teachers about ways to promote speech/language development for their children and students.  This collaboration between speech-language pathologist and parents/teachers lead to increased gains and generalization of communication skills. Success in clinical practice is part of the triad necessary for evidence-based practice. The three components are clinical expertise, current external research evidence, and client/patient preferences. So yes it is possible to implement quality speech & language services during individual and group speech language sessions that will contribute to students’ progress and mastery of learning objectives.

Nevertheless, I have found that I have more time to reflect about the success or struggles of each child and how to tweak future sessions to foster growth of communication skills, when I have the luxury of working 1-on-1 with a child. This does not mean that SLPs do not reflect on the quality of their group sessions and make changes as needed. However, I have found that SLPs are able to reflect more frequently on the delivery of their therapy and students’ progress with less kids served each day and week. In these scenarios, access to an evidence-based intervention program may very well enhance the lessons taught during group therapy sessions and contribute to overall students’ gains of communication goals.

During individual sessions, SLPs naturally use research based strategies  or approaches such as visual supports, verbal prompts, verbal cues, cycles approach, and language expansions or recasting to elicit children’s speech articulation/phonology targets or specific language skills during therapy.  It is possible to implement some strategies and approaches when you provide group therapy sessions such as using literature/evidenced based lessons. I have found that there is greater success when you focus on 1-2 things to teach the entire group in therapy. For example, during a read aloud of a fiction story, an SLP may emphasize the characters, character traits, and overall plot development. In other sessions, the SLP may emphasize key words with student’s articulation targets from the book or tier 2 challenging vocabulary. During these mixed groups, each child typically has different skills to practice. The use of strategies are an integral part of effective speech-language therapy. But, what about intervention programs that have been proven to be successful for certain communication, language, and literacy disorders?

It is imperative that SLPs have good therapeutic systems available to facilitate more effective individual and group sessions. These systems or intervention/curriculum programs provide SLPs with the framework they need to teach speech/language skills and guide accompanying intervention activities that will target a variety of  students’ speech/language objectives during each session.  This is one of the reasons that I started thinking about speech/language intervention programs that may be effective for all students  with communication disorders including those at risk for reading and writing disorders (SLD). Here’s a list of  programs and intervention approaches categorized by communication disorders and learning needs:

DISCLAIMER: BSL Speech & Language Services does not endorse all intervention and curriculum programs listed below. However, I have found some research evidence to show children making gains as a result of these intervention programs. These are indicated below with an *EB and the others with NOT EB. I have included my complete reference list at the end of this blog article. Children and adolescents may make progress in speech language therapy without these programs, but they do so under the clinical expertise of a state licensed and/or ASHA certified SLP. Similarly, the specialized certification programs are designed to improve the quality of the delivery of speech-language therapy. However, this does not mean that you must be certified in one of these programs to provide quality therapy. Children can make progress in speech-language therapy without working with an SLP with these certifications. However, these certifications often enhance the SLPs professional skills, delivery of evidence based practice,  and therefore further promote remediating communication and literacy disorders. Conversely not all available certification programs are considered evidence based according to current best practices. Note: Literacy programs listed below are often implemented by regular education teachers, special education teachers, and literacy specialists. According to ASHA, literacy instruction is also within the scope of practice for speech-language pathologists. However, SLPs will need continued education training in literacy assessment and intervention. Over time, SLPs may specialize in certain areas within the field of speech-language pathology. In doing so, they are able to enhance their delivery of quality speech-language therapy services).

CHILDHOOD APRAXIA OF SPEECH:

Integral Stimulation (IS)- *EB  This intervention approach requires a child to imitate utterances modeled by the speech-language pathologist. It requires both auditory and visual attention to improve speech motor movements.  IS is often referred to as the “listen to me, watch me, do what I do” approach.

Dynamic Temporal and Tactile Cueing (DTTC)- *EB    This intervention approach is based on foundational principles of  Integral Stimulation and a hierarchy of cueing that varied the relationship between the stimulus and response. It typically begins with simultaneous production of the utterance and later the child will be cued to directly imitate speech motor movements after a set criteria of mastery was met. As a child’s speech sound production and intelligibility improves,  certain cues are faded out.

 http://www.speechandlanguage.com/ebp/pdfs/EBPV9A5.pdf

*EB  There is  additional research evidence to support intervention programs that incorporate combining motor planning and sensory cueing. The researchers reviewed 23 single-case experimental studies and concluded the following to be evidence based: 

DTTC (Dynamic Temporal and Tactile Cueing) – *EB effective with clients with more severe CAS

Integrated Phonological Awareness Intervention-*EB effective with kids ages 4–7 years with mild to severe CAS

ReST (Rapid Syllable Transition Treatment) -*EB effective with kids ages 7–10 years with mild-to-moderate CAS

Murray, E., McCabe, P., et al. (2014). A Systematic Review of Treatment Outcomes for Children with Childhood Apraxia of Speech; American Journal of Speech-Language Pathology, 23, 486-504.

http://www.asha.org/EvidenceMapLanding.aspx?id=8589936369&recentarticles=false&year=undefined&tab=all

PROMPT- *limited EB     CERTIFICATION AVAILABLE   promptinstitute.com, entwellbeing.com.au

ARTICULATION/PHONOLOGICAL PROCESSES:

Beckmann Oral Motor Intervention- NOT EB   CERTIFICATION AVAILABLE

Cycles Approach by Hodson- *EB   This is used to reduce and eliminate the occurrence of phonological processes such as final consonant deletion and cluster reduction in a systematic manner.

PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets)- NOT EB   It provides a tactile-kinesthetic therapy technique to improve speech pronunciation. This is not a proven EB program for phonological disorders.  CERTIFICATION AVAILABLE

AUDITORY MEMORY:

*A child who has auditory memory difficulties usually has other receptive language or literacy areas of need.

HearBuilder- *EB  This is an online program that teaches, provides practice opportunities, and tracks a child’s performance in a hierarchy of memory skills.

AUGMENTATIVE & ALTERNATIVE COMMUNICATION:

iPad used as a Speech Generated Device (SPD) – *EB

The researchers reviewed 15 studies about the use of SPD, manual signs, and PECS with people with autism and other developmental disabilities. Tablet-devices such as the iPad were found to be highly effective in increasing communication skills in these populations. Caregivers also had positive perceptions about the use of the iPad with specific apps such as Proloque2Go

Alzrayer, N., Banda, D.R. & Koul, R.K. Rev J Autism Dev Disord (2014) 1: 179.

http://www.asha.org/articlesummary.aspx?id=8589957415

https://link.springer.com/article/10.1007%2Fs40489-014-0018-5

http://www.asha.org/EvidenceMapLanding.aspx?id=8589942945&recentarticles=false&year=undefined&tab=all

EARLY INTERVENTION/PARENT TRAINING:

Hanen It Takes Two to Talk – *EB   Parents of children birth to 5 years old are taught strategies to increase communication skills in their children with language delays.

http://www.hanen.org/Helpful-Info/Research/It-Takes-Two-to-Talk-Parent-Research.aspx        CERTIFICATION AVAILABLE

INFANT & CHILD FEEDING:

Beckmann Oral Motor Intervention- not EB; However Debra Beckman, M.S., CCC-SLP indicates this is warranted when an oral motor deficit has been determined via an assessment

Behavioral Intervention- *EB    Various types of behavioral interventions such as differential attention, positive reinforcement, escape extinction/escape prevention, stimulus fading, simulatenous presentation, differential reinforcement of alternative behavior (DRA), and use of a flipped spoon as a presentative method have been found to be effective in increasing food intake for children with severe feeding problems. This is specifically geared towards infants, children, and adolescents with oral feeding problems, chronic food refusal, selectivity, failure to advance texture, and inappropriate mealtime behaviors such as throwing food and temper tantrums. Behavioral intervention is not indicated for pre-term babies with oral motor immaturity or children with eating disorders such as anorexia or  bulimia.

(University of Cincinnatti- Best Clinical Evidence Statement)- Retrieved May 31, 2007. Scroll down to Feeding. https://www.cincinnatichildrens.org/service/j/anderson-center/evidence-based-care/recommendations/topic

 

PHONOLOGICAL AWARENESS:

* EB   Overall, phonological awareness training paired with letter knowledge training has positive effects on phonological processing and early reading & writing skills.

 https://ies.ed.gov/ncee/wwc/EvidenceSnapshot/376

FastForward- *EB for phonemic awareness, not EB for reading fluency, mixed outcomes for reading comprehension   https://ies.ed.gov/ncee/wwc/EvidenceSnapshot/172

LIPS by Lindamood Bell- *EB    Research indicates positive outcomes on alphabetics and reading fluency    https://ies.ed.gov/ncee/wwc/EvidenceSnapshot/279   CERTIFICATION 

Lively Letters by Reading TLC- *EB   CERTIFICATION AVAILABLE

HearBuilder- *EB

Earobics- *EB

Fundations by Wilson Reading System- NOT EB. This is a reading program for K-3rd grade that is often used in schools to remediate print knowledge, phonological awareness,  phonemic awareness, decoding, spelling. However, many special education teachers report that students make reading gains using this program.

https://ies.ed.gov/ncee/wwc/EvidenceSnapshot/196

PRAGMATIC LANGUAGE:

Social Thinking Training Program- not EB (Leaf et al. 2016) However, creators report that it is a therapeutic methodology based on research based practices such as modeling and naturalistic intervention).  CERTIFICATION AVAILABLE

 

RECEPTIVE & EXPRESSIVE LANGUAGE: 

Expanding Expression Tool (EET)- *EB   This is a multisensory tool that teaches kids how to improve their descriptive language skills. Research shows gains in oral language and written expression.  expandingexpression.com

Narrative Intervention with Macrostructure and Repeated Retell- *EB    http://www.asha.org/articlesummary.aspx?id=8589954067

*Review of  9 research studies confirm that direct narrative instruction in speech-language therapy leads to gains in story grammar elements of character, setting, initiating event, internal response, plan, attempts, direct consequence and resolution (macrostructure). It also leads to gains in language structure (microstructure) of clauses, elaborated noun phrases, cohesive ties, mental state verbs (e.g. remember, think, know, realize), linguistic verbs (e.g. exclaimed, whispered), and adverbs.

Story Grammar Marker by MindWing Concepts, Inc.- *EB     mindwingconcepts.com

Talkies by Lindamood Bell- *EB  CERTIFICATION AVAILABLE

Visualizing and Verbalizing by Lindamood Bell- *EB     http://lindamoodbell.com/article   CERTIFICATION AVAILABLE

SPEECH FLUENCY/PARENT TRAINING:

Demands & Capacity Model- *EB

Lidcombe- *EB    CERTIFICATION AVAILABLE

The Lidcombe program  has been found to be effective in decreasing stuttering for children 2-6 years old.  It is a fluency shaping program that emphasizes parent training to reduce their child’s stuttering at home.  You can read more about it here.Read this ASHA presentation information about the effectiveness of the Lidcombe program here.

Pharmaceuticals with Speech Fluency Therapy- NOT EB

“The treatment of stuttering in children between the ages of six and thirteen years should be based on a treatment plan that contains all ICF [International Classification of Functioning] elements and focuses on the types of behaviors, emotions and cognitions that have been identified, in collaboration with the child who stutters and his parents during assessment.”

“Use of pharmaceuticals in the context of stuttering therapy is not recommended. Where there is co-morbidity and stuttering, it is recommended that an appropriate choice and dose of pharmaceuticals is sought in consultation with the PWS (and their direct environment) and the prescriber.”

Pertijs, M.A.J., Oonk, L.C., Beer, de J.J.A., Bunschoten, E.M., Bast, E.J.E.G., Ormondt, van J., Rosenbrand, C.J.G.M., Bezemer, M., Wijngaarden, van L.J., Kalter, E.J., Veenendaal, van H. (2014). Clinical Guideline Stuttering in Children, Adolescents and Adults. NVLF, Woerden

“It is recommended that Speech-language pathologists (SLPs) provide services with a home program component for preschool and school age children who stutter to reduce their percent stuttered syllables (%SS)”

Best Evidence Statement (BESt). Evidence Based Practice for Stuttering Home Programs in Speech-Language Pathology 

Mewherter, M., & Cincinnati Children’s Hospital Medical Center. (2012). Cincinnati (OH): Cincinnati Children’s Hospital Medical Center, (BESt 137), 1-7.

http://www.asha.org/articlesummary.aspx?id=8589960659

LITERACY:

Earobics – *EB    https://ies.ed.gov/ncee/wwc/EvidenceSnapshot/158

Research has shown that this program can benefit at-risk students, students in general and special education classes, and ESOL students. Research confirms positive effects on phonemic awareness, phonics, and reading fluency.

Edmark-  NOT  EB; However, special education teachers report reading gains with children with cognitive impairment and learning challenges

https://mapsdspecialeducation.wikispaces.com/file/view/FCRR+Edmark+Reading+Program.pdf

Fountas & Pinnell Intervention Kit- *EB

Great Leaps- *EB    http://sosaschool.com/files/GreatLeapsReport.pdf

HearBuilder- *EB

Orton Gillingham- *EB  CERTIFICATION AVAILABLE

Read 180- *EB   Positive effects on reading fluency and comprehension for children 2 or more grade levels behind   https://ies.ed.gov/ncee/wwc/EvidenceSnapshot/172

Reading Workshop (application for SLPs) * EB- See last blogpost

Seeing Stars by Lindamood Bell- *EB   CERTIFICATION AVAILABLE

SPIRE- *EB   for Special Education and English Language Learner (ELL)   http://eps.schoolspecialty.com/EPS/media/Site-Resources/Downloads/research-papers/SPIRE-effectiveness.pdf

Wilson’s Reading- *NOT EB; although special education teachers report students’ reading gains   https://ies.ed.gov/ncee/wwc/EvidenceSnapshot/547

BEHAVIOR INTERVENTION:

Why is this important to SLPs? SLPs may refer clients and their families to seek skilled behavior therapy to enhance their life success at home, school, and in the community.

ABA Therapy- *EB

It is an evidence based allied health approach to assess behaviors and develop individualized intervention plans to decrease challenging behaviors, increase functional communication for children with complex communication needs, increase task compliance  while monitoring clients’ performance and providing positive reinforcement.

This intervention is often provided to children and adolescents with autism and other developmental disorders. It can be provided by the following trained staff:

Board Certified Behavior Analyist (BCBA)- Master’s level clinician

Board Certified Assistant Behavior Analysis Assistant (BCaBA)- Bachelor’s level clinician

Registered Behavior Technician (RBT)- Minimum of High School Diploma and 40 hours of training, pass the RBT Competency Assessment, paraprofessional under the close supervision of a BCBA or BCaBA

**********************************************************************************************************************************************************

REFERENCES:

http://www.asha.org/Evidence-Maps/    All Communication Disorders

ASHA provides the most current research for speech-language pathologists on a variety of communication disorders.

http://www.asha.org/articlesummary.aspx?id=8589953616     Childhood Apraxia of Speech

Practicalaac.org (PrAACtical Conversations: Nonspeech Oral Motor Exercises) http://praacticalaac.org/praactical/praactical-conversations-nonspeech-oral-motor-exercises/  Oral Motor/Articulation

Bowen, C. (2011). Controversial practices in children’s speech sound disorders. Retrieved from http://www.speech-language-therapy.com/ on 5/31/17     Oral Motor

https://www.cincinnatichildrens.org/service/j/anderson-center/evidence-based-care/recommendations/topic   Feeding

http://bacb.com     ABA Therapy

http://www.asha.org/EvidenceMapLanding.aspx?id=8589942945&recentarticles=false&year=undefined&tab=all    Alternative and Augmentative Communication

http://www.asha.org/articlesummary.aspx?id=8589960659   Speech Fluency Home Programs

https://iris.peabody.vanderbilt.edu/ebp_summaries/

https://iris.peabody.vanderbilt.edu/iris-resource-locator/

The IRIS Center is funded by the U.S. Department of Education’s Office of Special Education Programs (OSEP). It is located at Vanderbilt University in Nashville, Tennessee and Claremont Graduate University in Claremont, California. The center creates resources about evidence-based practices for professional development.

https://ies.ed.gov/ncee/wwc/EvidenceSnapshot/196      Phonologial Awareness: Fundations by Wilson

lindamoodbell.com         Talkies, LIPS, Visualizing and Verbalizing Programs         Phonological Awareness, Phonemic Awareness, Receptive/Expressive Language

mindwingconcepts.com    Story Grammar Marker    Narrative Development

socialthinking.com     Pragmatic Language/Social Cognitive Deficits    Autism

http://www.hanen.org/Programs/For-Parents/It-Takes-Two-to-Talk.aspx   Early Intervention

http://www.ortonacademy.org/approach.php       https://www.orton-gillingham.com           Orton Gillingham

http://www.fcrr.org/resources/resources_vpk.html    Florida Center for Reading Research Vocabulary and Learning Resources

The Florida Center for Reading Research was established in 2002 to conduct basic research on reading, reading growth, reading assessment, and reading instruction that will contribute to the scientific knowledge of reading and benefit students in Florida and throughout the nation. There are three other centers, one at the University of Colorado (http://ibgwww.colorado.edu/cldrc/), Texas Center for Learning Disabilities at the University of Houston (http://www.texasldcenter.org/) and the Center for Defining and Treating Specific Learning Disabilities in Written Language at the University of Washington (https://education.uw.edu/faculty-and-research/centers).

https://ies.ed.gov/ncee/wwc/EvidenceSnapshot/158   Earobics

http://www.coe.fau.edu/centersandprograms/card/documents/EducationalResourcesManual.pdf   Educational Resources for Children With Autism (Compiled by University of Miami and NovaSoutheastern University

https://www.expandingexpression.com/    Expanding Expression Tool

apraxia-kids.org   

Note: This blog post will be updated at times. Please contact me if you have comments, questions, or concerns about information provided. Remember reviewing evidence and providing reference list related to communication disorders is a lengthy process. Thanks for your support!  I hope that you will find at least 1-2 new intervention programs or approaches  to implement in speech-language therapy. You may even desire to attain specialized training and certification in programs such as Lidcombe, Lively Letters, Lindamood Bell, Hanen, or ABA Therapy. Best of luck in your professional development and success for your speech-language clients and students!

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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