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

welcomed from CP’s parents who were <strong>of</strong>ten the first to notice speech skills worked on
in clinic being used spontaneously at home.
Treatment techniques began by establishing consistent production <strong>of</strong> target
sounds in single syllable productions using first established vowel sounds. As CP’s
consistency increased during drill practice, the environment in which the targets were
presented increased in complexity. Word shape complexity, syllable numbers, phrase
lengths, and conversational contexts were increased as CP’s pr<strong>of</strong>iciency grew.
A variety <strong>of</strong> visual, auditory, and tactile supports were employed by the clinician
to assist CP in achieving correct productions <strong>of</strong> target sounds. Clinician models included
visual and auditory productions <strong>of</strong> target sounds using a mirror and face to face
interaction. CP was instructed to watch the clinician’s mouth and listen carefully. CP was
directed to produce sounds first simultaneously, then imitatively, and later with delayed
imitation, and with a variety <strong>of</strong> visual supports such as foam letters, written words,
mouthed imitations, and pictorial depictions <strong>of</strong> oral placements. Tactile gestures were
provided to indicate the location <strong>of</strong> articulator contacts. CP was encouraged to feel his
throat during voiced productions and feel oral air emissions with his hand during
appropriate sound productions (stops and fricatives). Signed letters were occasionally
used to stimulate CP’s awareness <strong>of</strong> upcoming target sounds before producing them.
Supports were faded as the accuracy <strong>of</strong> CP’s productions increased.
Feedback <strong>of</strong> CP’s speech sound performance was <strong>of</strong>fered in the form <strong>of</strong> specific
knowledge <strong>of</strong> results. Both correct and incorrect productions were given feedback.
Correct productions would <strong>of</strong>ten be followed by statements such as; “Hey, those top teeth
are touching your bottom lip!” or “I heard a hissing /s/ sound.” Incorrect productions <strong>of</strong>
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