Effects of integral stimulation therapy on speech - Portland State ...

At age 3 1/2, CP’s pediatrician referred him to the Oregon Health Sciences
University for a speech-language evaluation where he received a diagnosis <strong>of</strong> childhood
apraxia <strong>of</strong> speech. At the age <strong>of</strong> 4, CP began receiving speech and language services from
a private speech language pathologist and briefly through a pre-school early intervention
program. Early intervention services included a 90 minute language group once a week.
CP’s private individual speech-language services twice per week for 45 minutes were
ongoing. CP’s parents discontinued intervention from early intervention services when
they decided his speech needs would be better served by increased individual speechlanguage
services. During this period CP was enrolled in a child-parent sign language
class to increase his natural use <strong>of</strong> gestures to facilitate communication at home. CP’s
parents and speech services provider found that his use <strong>of</strong> signed words alleviated
frustration during CP’s miscommunications and increased his verbal attempts for words
when paired with gestures. Speech <strong>therapy</strong> consisted primarily <strong>of</strong> establishing simple
syllable shapes using early developing speech sounds. As CP’s phonetic inventory
increased, new developmentally appropriate sounds were added to treatment goals, and
syllable shapes moved from open to closed and reduplicated syllable shapes. Therapy
techniques utilized multimodal means <strong>of</strong> support including gestural, tactile, kinesthetic,
auditory, visual, oral motor exercises, and bite block treatment strategies. Drilled practice
activities were numerous yet brief to discourage fatigue. Further, objectives were
changed on an ongoing basis to provide the support and flexibility needed to adapt to his
communicative progress.
CP was referred to the Portland State University Speech-Language and Hearing
Clinic for a second diagnostic evaluation. Findings <strong>of</strong> the assessment supported the
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