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

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Conclusion The results <strong>of</strong> this study suggest that use <strong>of</strong> an <strong>integral</strong> <strong>stimulation</strong> approach as a treatment for CAS resulted in increased accuracy <strong>of</strong> target phonemes within untrained carrier phrases in all target sound sets. Post treatment data results indicate that CP’s speech sound accuracy was maintained in 3 out <strong>of</strong> the 4 phoneme sets 2 weeks following withdrawal <strong>of</strong> treatment. These results suggest that motor learning had occurred within post-treatment carrier phrases. Additionally, CP’s parents and clinicians observed an increase in the frequency and accuracy <strong>of</strong> target speech sounds in conversational speech contexts. Results <strong>of</strong> spontaneous language samples taken before treatment and near the end <strong>of</strong> treatment show marked improvement in mean length <strong>of</strong> utterance and consonant accuracy. CP’s significant speech progress over the course <strong>of</strong> 21 weeks (33 treatment sessions) was due to the fact that many precursors to motor learning were in place when he began <strong>integral</strong> <strong>stimulation</strong> <strong>therapy</strong>. A child’s level <strong>of</strong> motivation can be influenced by his or her cognitive functioning, comfort level, social/self awareness, and rapport with the clinician. CP demonstrated a high degree <strong>of</strong> motivation during most <strong>of</strong> his treatment sessions. He was able to apply focused attention to speech tasks for short periods <strong>of</strong> time; <strong>of</strong>ten evaluating the accuracy <strong>of</strong> his own speech and making corrections. CP’s soundletter skills were well developed so that many speech tasks were reinforced by his eagerness to read and “sound out” his words in mirrors and when playing games. His mother attended each speech session, <strong>of</strong>ten participated in <strong>therapy</strong> activities with her child, and then used them later at home and in school to facilitate the generalization <strong>of</strong> speech skills in a number <strong>of</strong> contexts. 70
CP’s cognitive functioning contributed to his success in being able to understand and respond to feedback provided to him during <strong>integral</strong> <strong>stimulation</strong> <strong>therapy</strong> sessions. Typically, CP responded most favorably to visual, tactile, and auditory cues presented within the contexts <strong>of</strong> motivating activities (building, games, books). He was able to “be his own judge” with simple supports, and moved toward independently correcting his own speech errors. Strengths <strong>of</strong> this study include a solid single subject design and data tracking system. The clinician possessed a high level <strong>of</strong> understanding <strong>of</strong> <strong>integral</strong> <strong>stimulation</strong> <strong>therapy</strong> and remained under the supervision <strong>of</strong> a certified speech-language pathologist specializing in diagnosis and treatment <strong>of</strong> CAS. Treatment sessions were planned and executed with attention to providing the child with a hierarchy <strong>of</strong> multi-modal cueing supports that were adaptive to his level <strong>of</strong> need in each treatment session. Sessions were broken up into a series <strong>of</strong> short, but fast-paced activities to minimize the possibility <strong>of</strong> fatigue or disinterest during speech motor practice. Blocked speech practice was initially used to establish CP consistent motor speech skills, then practiced randomly with other speech targets. Therapy sessions were broken into short activities so that CP had to “relearn” motor skills in different contexts and so that he did not tire after frequent and intense motor practice tasks. He was <strong>of</strong>fered “play breaks” when he indicated that he needed them. Limitations <strong>of</strong> this study included occasional sessions when the child was feeling ill or uncooperative during speech probes and treatment sessions. At these times, less practice was achieved as more attention was spent on re-focusing this energetic 5 yearold boy. 71
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EFFECTS OF INTEGRAL STIMULATION THE
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stimulation <stron
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Table of Contents
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List of Figures Fi
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The committee recognized that ident
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melodic support to overcome sound s
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Literature Review The differential
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part affect the numbers diagnosed a
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discrepancy suggests the probabilit
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neuromuscular impairment (Caruso &
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execute smooth and accurate speech.
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Table 1. Rosenbek et al.’s Hierar
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methodologies have yielded less con
Page 28 and 29: associated with the practice or exp
Page 30 and 31: very nature of spe
Page 32 and 33: Integral Stimulation and Childhood
Page 34 and 35: stimulation <stron
Page 36 and 37: period of no treat
Page 38 and 39: diagnosis of moder
Page 40 and 41: Table 3. Summary of</strong
Page 42 and 43: Table 4. Summary of</strong
Page 44 and 45: Word Shapes Simple word shapes such
Page 46 and 47: Hearing Hearing evaluations were co
Page 48 and 49: target sounds would allow CP a mana
Page 50 and 51: adjective, and a noun or verb (see
Page 52 and 53: welcomed from CP’s parents who we
Page 54 and 55: simultaneously with the child, prov
Page 56 and 57: to restart the mental processes nee
Page 58 and 59: Analysis of speech
Page 60 and 61: Results This study examined the eff
Page 62 and 63: Post-Treatment Results for /s/ Clus
Page 64 and 65: Data Results for Labiodentals Frica
Page 66 and 67: Data Results for Affricates: /ȴ/ &
Page 68 and 69: Data Results for Interdental Fricat
Page 70 and 71: Figure 4. Percent correct for /θ/
Page 72 and 73: Discussion This discussion examines
Page 74 and 75: practice his motor speech skills in
Page 76 and 77: Indicators that motor learning had
Page 80 and 81: A number of sessio
Page 82 and 83: References American Speech-Language
Page 84 and 85: Delaney, A.L., & Kent, R.D. (2004,
Page 86 and 87: Powell, T. W. (1996). Stimulability
Page 88 and 89: Strand, E. A. (1995). Treatment <st
Page 90 and 91: for regular treatment are determine
Page 92: Appendix C -Data Tracking Form TX T
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Effects of integral stimulation therapy on speech - Portland State ...

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