Update on T...

I only have four more sessions with T, and I am happy to say that he has made some major progress in the last several weeks. His articulation is slowly improving, as well as his ability to answer questions appropriately. One thing he always gets stuck on is his age. When I ask him how old he is, he tells me his name. I have tried many times to explain that the answer to this questions is a number. If anyone else has suggestions, I welcome them!

We have been working with a lot of minimal pairs in the last few weeks. Sometimes when I ask T to "point to hall; point to call" he points to the correct one, but sometimes he does not. I don't know if he is guessing, but he seems to know the more common words. Some of the words in my list may be a little unfamiliar to him, which could certainly cause some confusion.

I have read that it is best to use minimal pair treatment when the target phoneme is completely absent from the child's phonological index (Barlow and Gierut, 2002). However, T's articulation is so inconsistent that I thought I would give it a try. It seems to be working, slowly.

My supervisor and I have also questioned if T may have a little bit of apraxia because of his inconsistencies. He can say a word one minute, and the next time he can't. Maybe this should be an area to investigate further in the next couple of weeks.

That's about all - I hope everyone enjoys the last two weeks of clinic!

Reference:
Barlow, Jessica A. and Gierut, Judith A. (2002) Minimal pair approaches to phonological remediation. Seminars in Speech and Language (23) 1; 57-67.

Second Semester

The second semester is almost halfway over already! I can not believe how quickly grad school is going. My new client this semester, T, is a VERY cute 3 year old with delayed speech and language. Last semester his goals were mostly focused on language: WH questions, yes/no questions, increasing MLU, etc. Apparently, he had a huge language "growth spurt" over the last several months, and his MLU seems to be right on target now. He still has some trouble with WH questions, especially "when" and "how." Right now I give him two choices while working on those questions, and he seems to be improving.

T's main problem, in my opinion, is not his language but his speech. He demonstrates everything that Dr. Ruscello taught us were red flags: initial consonant deletion, glottal stopping, and the occasional backing of sounds. He is stimulable for almost every sound, but his phonological rules are incomplete. For example: Last week we were working on the initial /p/ in /pIg/, and he would say /p....p....kIg/. I read a book of rhyming words to him (AKA minimal pairs), and this week I am going to include many more minimal pairs in the sessions. My goal is to teach him that he needs to make his sounds in the right places for people to understand him (Geirut, 1998). The challenge will be keeping his attention and finding fun activities to do while motivating him to improve his speech. He is extremely active and loves to change tasks often before we are really finished!

Reference:
Geirut, Judith A (1998). Treatment efficacy: Functional phonological disorders in children. Journal of Speech, Language, and Hearing Research, 41 (S85-S100).