speech motor chaining procedures - speech production …speechproductionlab.syr.edu/_pdfs/chaining...

Licensed under a Creative Commons Attribution 4.0 International License. Suggested Citation: Preston, J.L., & Leece, M.C. (2016) Speech Motor Chaining Procedures: Treating speech sound errors with

chaining and principles of motor learning. Syracuse, NY, USA: Syracuse University. Retrieved from: http://speechproductionlab.syr.edu/Resources%20for%20Researchers.html

SPEECH MOTOR CHAINING PROCEDURES TREATING SPEECH SOUND ERRORS WITH CHAINING AND PRINCIPLES OF

MOTOR LEARNING

DEVELOPED BY: SYRACUSE UNIVERSITY SPEECH PRODUCTION LABORATORY

DR. JONATHAN PRESTON, DIRECTOR, & MEGAN C. LEECE, LABORATORY MANAGER

621 SKYTOP ROAD, SUITE 165-00 SYRACUSE, NY 13244 [email protected]

VERSION 1.1 DECEMBER 7, 2016

http://creativecommons.org/licenses/by/4.0/

http://speechproductionlab.syr.edu/Resources%20for%20Researchers.html

1 Licensed under a Creative Commons Attribution 4.0 International License.

SPEECH MOTOR CHAINING PROCEDURES Background and Motivation

Persisting speech sound errors are a result of incorrect articulatory configurations (e.g., Boyce, 2015). When addressing these sound errors in speech therapy, many speech-language pathologists (SLPs) see improvements in their clients’ performance on speech sounds in the therapy room settings; however, clients sometimes fail to generalize these skills outside of the clinic/therapy room. To address this need, we have devised a practice procedure designed to initially facilitate acquisition of a target speech sound/movement and systematically transition to a focus on generalization.

Several principles of [speech] motor leaning (PML) have been derived from non-speech motor learning literature. Most importantly, these principles define a specific difference between acquisition of a skill versus learning of a skill (Maas et al., 2008; Schmidt & Lee, 2011). According to these principles, acquisition refers to motor performance during therapy. In the case of speech therapy, acquisition may refer to speech sound accuracy within a session or on a specific task. Conversely, learning refers to later retention and generalization of a motor skill. Thus, some clients show acquisition of correct articulatory configurations (improved accuracy during sessions), but fail to demonstrate learning (as defined by retention and generalization after the session

Broadly stated, the goal of speech therapy is to promote consistent production of articulatory movements that results in an acoustically-acceptable production of phonemes in all word positions during spontaneous conversation. Thus, the ultimate goal of speech therapy is learning, specifically defined by retention of acquired skills and generalization to novel contexts. ). In general, the treatment described here involves an initial emphasis on acquisition followed by steps toward motor learning.

In addition to motor learning, our procedures are set up such that stimuli are chained. The general purpose of chaining is to gradually build complexity of speech movements. Chaining procedures have been described for many years in the speech disorder literature (Chappell, 1973; Johnson & Hood, 1988; Preston, Brick & Landi, 2013; Young, 1987). The procedures described here are an attempt to formalize and operationalize chaining for the purposes of clinical practice and clinical research.

This document outlines chaining procedures that we use in our research, along with some relevant theoretical foundations. These chaining procedures incorporate several principles of motor learning (PML) and may promote generalization and retention of speech sounds for remediation of residual speech sound errors.

Some Notes on the Speech Motor Chaining Procedures

These procedures have been used in a number of studies (see References). For example, they have been studied as part of treatment with children, adolescents, and adults with residual speech sound errors, with children with childhood apraxia of speech, and with an adult with acquired apraxia of speech. They have also been used in the Gebbie Speech-language Clinic at Syracuse University.

These procedures can be used both with and without biofeedback. Although the procedures were developed as part of a series of studies that included biofeedback, the chaining procedures are always used in each session without biofeedback as well.



Datasheet A datasheet has been devised to guide users to implement the chaining procedures. A portion of the datasheet is shown below for reference; a sample of a full datasheet is in Appendix A (p. 13). In addition to clinician and client information, the datasheet includes the target sequences that are addressed at the top of the sheet. The majority of the datasheet shows the list of chains that are to be practiced, which build from simple syllables to multisyllabic words. The client’s performance is assessed after every 6 trials to determine whether practice should build to a more complex target (moving to the right on the datasheet) or whether practice should switch to a different target chain (moving down on the datasheet). The criterion of 5/6 correct is required to move to more complex targets. Thus, on the datasheet each trial can be scored, and a sum is computed after each block of six attempts.

The datasheet also provides information for the SLP to guide feedback. Definitions of knowledge of results (KR) and knowledge of performance (KP) feedback are provided on page 5.



TARGET SELECTION When selecting targets for Speech Motor Chaining procedures, we typically treat a two-phoneme sequence (CV, VC, or CC). This allows us to address not only a phoneme but a movement pattern. For example, a client with /r/ distortion might be treated with the general patterns /rV/, /Vr/ and /Cr/.

Some considerations for defining phoneme sequences are provided below:

1. Stimulability within phonetic context. If a client is somewhat stimulable in one phonetic context, it is important to try to practice that facilitative context in at least 1 chain to allow the client to experience some success. If the client is not stimulable in any context, syllables can be chosen which may be facilitative (e.g., /ɑr/ may be potentially facilitative for /r/ distortions because /ɑ/promotes pharyngeal constriction; /ts/ may be facilitative for /s/ distortions due to the presence of an alveolar stop).

2. Variety of phonetic context. Target sequences should represent a variety of vowels to encourage accurate production of phonemes across a wide variety of coarticulatory contexts. To accomplish this, NON-ADJACENT VOWELS should be utilized (e.g., /ri, ro, rɑ/ to address rV sequences). Select vowels from different quadrants of the vowel quadrilateral (see figure) to create sequences. In the case of clusters (initial or final) or nucleus /ɝ/, where the /r/ is being used as a vowel (e.g, “bird”), sequences can incorporate consonants of varied place, manner, and voicing.

Image Source: http://everydaylanguage.qwriting.qc.cuny.edu/2013/10/19/vowels-in-ipa/

The following are examples of target selection that encourages varied use of vowels (including a note about the variants addressed). Note: the /ʧ/ chain does not incorporate VCC, because you can’t add a final blend in multiple contexts in monosyllables:

/r/ onset /s/ onset /r/ rhyme /ʧ/ rhyme

/rɑ/ /si/ /or/ /iʧ/ /ri/ /sæ/ /er/ /æʧ/

/bru/ /stu/ /ɝl/ /ʌʧ/ /tre/ /sno/ /ɝk/ /ɪʧ/

2 rV, 2 CrV 2 sV, 2 sCV 2 Vr, 2 ɝC 4 Vʧ

Within the target category, up to four different variants are typically practiced in a session. The four variants consist of: CV onsets, CCV onsets, VC coda, VCC coda. The number of variants addressed depends on what is phonotactically allowable. For example, /ʧ/ is not treated as a consonant cluster, while /r/ may be treated as both a consonantal segment


http://everydaylanguage.qwriting.qc.cuny.edu/2013/10/19/vowels-in-ipa/


(e.g., /rV/, /Cr/) and a vocalic segment (e.g., /ɝC/, /Vr/). Once sequences are chosen, the individual chain levels are organized around adding complexity around that sequence (the sequence remains constant across the chain).

Levels

A level is defined by complexity. We define five levels of complexity for the target category:

1. Syllables: CV or VC (or other phonotactically allowable sequence)

2. Monosyllabic words: beginning or ending with the target sound sequence, must contain an onset and a coda

3. Multisyllabic words: 2-3 syllables, beginning or ending with the target sound sequence, must contain the monosyllabic word or syllable.

4. Phrases: 2-4 words, begin or end with a monosyllabic word or a multisyllabic word

5. Self-generated sentences: clients have to use either a monosyllabic word or multisyllabic word in a self-generated sentence

Some example chains are shown below.

SYLLABLE MONOSYLLABLIC WORD

MULTISYLLABLIC WORD

BLOCKED PHRASE

SELF-GENERATED SENTENCE

/rɑ/ rot rotten rotten food ?

/or/ for before just before ?

/bru/ broom broomstick fly on a broomstick

?

/ɝl/ girl early early to bed ?

/sɪ/ sit sitting sitting down ?

/æst/ cast broadcast national broadcast

?

/ʧæ/ champ champion world champion ?

/ɪʧ/ witch sandwich eat a sandwich ?

**note how the target sequence remains consistent throughout the chain (bold).

Other examples of chains used in therapy can be found on the lab website: http://speechproductionlab.syr.edu/Files/Words%20for%20Tx-chains.pdf


http://speechproductionlab.syr.edu/Files/Words%20for%20Tx-chains.pdf


EXAMPLES OF FEEDBACK DURING PRACTICE The following examples are provided to help SLPs differentiate Knowledge of Results feedback (KR) from Knowledge of Performance feedback (KP)

Knowledge of Results (KR) refers to providing the client with information only about the accuracy of the speech sound. Was the outcome a correct production or an incorrect production? KR feedback is typically associated with motor learning because the SLP is not providing specific information to the client about what movements the client has to change. Below are examples of the 3 types of feedback employed in the Structured Practice/Chaining procedures.

Positive KR Negative KR No Feedback

Good one Not that time Next one

You got it No Try another

Great Didn’t get that one Try again

Excellent Not that one And again

Way to go Not quite right Do another

Correct

That’s right

Nice

Knowledge of Performance (KP) refers to giving the client feedback about the nature of the movement they just performed. If s/he produces a sound in error, what aspect of their phonetic placement, vocal tract configuration, or movement sequencing need to change to achieve a correct production? If a target sound is correctly produced, what aspect of the movement can you highlight that resulted in correct production? KP feedback typically aids acquisition and is provided frequently in the early stages of treatment because the SLP offers specific information to the client about essential aspects of speech movements.

/r/: Correct /r/: Error

Good, your tongue tip was raised. Not quite. Lift the front of your tongue up a little.

Got it! Your sides were up. Not quite. Try to lift the sides up to touch the back molars.

Nice. You moved your tongue back. Not that time. Try to move your tongue back into your throat a little.

Yes, you got tongue root back into the throat

Not that time, try to pull the tongue root back into the throat.

Nice dip in the center of your tongue Not quite. Try to make a boat shape with the sides up and the middle down.



/k/: Correct /k/: Error

Awesome! You kept your tongue tip down. No. Both the tongue tip and the tongue dorsum were up on that one.

Good work. You raised the back of your tongue.

Not quite. You raised the tip higher than the back.

Great job lifting the dorsum up. Didn’t get the dorsum to be the highest part that time.

/s/: Correct /s/: Error

Nicely done! Your sides were up. Not quite. The middle and sides were even.

I like it! Your groove was nice and deep. Not that one…the groove was shallow and too wide.

Great job keeping the air moving the whole time.

No. The air stopped and didn’t move through the whole /s/ sound.

Got it. The groove was skinny. No. Remember to make the bird shape there.

Great. Good bird shape. Not that time. Remember to get your sides touching your front molars (not your back).

Cues can be adapted for whatever error the client makes most often (e.g., if the client is consistently raising the tongue tip for /r/, but not achieving tongue root retraction, provide feedback about tongue root retraction more frequently than feedback about tongue tip elevation).



SESSION STRUCTURE Speech Motor Chaining procedures are one component of treatment. Typically, our treatment sessions are initially divided into two phases: Pre-Practice/Elicitation and Structured Practice using Speech Motor Chaining.

Pre-Practice

Within the Pre-Practice/Elicitation phase, clinicians are trying to communicate a “minimum reference for correctness” (McCabe & Preston, 2016). This means we are trying to facilitate stimulability for production of the target sound with cueing. SLPs may use of a variety of strategies to achieve an accurate production of the sounds within the target category. This is done primarily by modeling, shaping, and verbal and visual cues for tongue placement/movement, strategies that are commonly employed in a client’s treatment program. For example, to address /r/, shaping strategies may involve /l//r/ or /ɑ//r/. Phonetic placement may consist of cues to elevate the anterior tongue, keep the dorsum low, elevate the sides of the tongue, retract the tongue root, or keep the lips steady.

Within the Pre-Practice/Elicitation phase, the SLP provides frequent cueing and immediate reinforcement to elicit correct productions from the client. In our approach, Pre-Practice/Elicitation strategies are used until the client achieves 6 correct productions of each variant. The ultimate goal of the Pre-Practice/Elicitation phase is to develop an internal referent of a “correct” production of the target sound.

Speech Motor Chaining

After 6 correct productions of each variant are achieved, advance to structured practice/feedback using the chaining data sheets (see Appendix A). The data collection sheet is designed to guide you through the following principles. Target syllables, words, and phrases will be elicited via direct imitation. Each time the Structured Practice with Speech Motor Chaining begins, start at the syllable level. During this stage, the feedback schedule varies by level, as follows:

1. Syllables (e.g., /re/, /ro/). Feedback is provided on 5 of 6 trials. The trial that gets no feedback is randomly determined in each block, but is guided by the data sheet. Feedback will include both knowledge of performance (related to tongue position) and knowledge of results (related to accuracy) on 4 trials and KR only on 1 trial.

Example:

Clinician: Ray /re/

Client: /re/

Clinician: “Good” (KR) “The sides were up”. (KP)

Or

Clinician: Ray /re/

Client: [r̬e]

Clinician: “No” (KR) “Try lifting the front higher”. (KP)



2. Monosyllabic words (e.g., rain, rope). Feedback is provided on 5 of 6 trials. Which trials get feedback are randomly decided per block. Feedback will include both KR+KR on 3 trials and KR only on 2 trials.

a. Advance to multisyllabic words if 5 of 6 trials are correct in the block.

b. Move back to syllable level of other variant if less than 5 of 6 correct in the block

3. Multisyllabic words (e.g., rainbow, tightrope). Feedback is provided on 3 of 6 trials. Which trials get feedback are randomly decided per block. Feedback will include both KR+KR on 2 trials and KR only on 1 trial.

a. Advance to phrases if 5 of 6 trials are correct in a block


4. Phrases. (e.g., rainy day, walk the tightrope). Feedback is provided on 3 of 6 trials. Which trials get feedback are randomly decided per block. Feedback will include both KR+KR on 2 trials and KR only on 1 trial.

a. Advance to self-generated sentences if 5 of 6 trials are correct in a block


5. Self-generated sentences (e.g., have the child come up with a sentence using “rainy”). Feedback is provided on 3 of 6 trials. Which trials get feedback are randomly decided per block. Feedback will include both KR+KR on 1 trial and KR only on 2 trials.

a. Move to syllable level of other variant.

b. Consider switching the chain for another similar chain (e.g., eliminate “rope” and use “roll”) if this is the second time in a session you achieve 5 out of 6 correct.

The criteria to advance or move to another syllable keep the client practicing at an appropriate Challenge Point in therapy (Hitchcock & McAllister Byun. 2015; Schmidt & Lee, 2011; Rvachew & Brosseau-Lapré, 2012). That is, clients work at the “just right” amount of difficulty. If the task proves too hard, they return to syllable level and practice again in conditions that are more acquisition focused (limited linguistic level/less complex, frequent feedback that is specific to performance) before attempting targets that are more learning focused (higher linguistic levels/more complex, sporadic feedback that is specific to results).

Session Timing & Random Practice Early in treatment, it is not unusual to spend the entire session in Pre-Practice/Elicitation, with few opportunities for Structured Practice via chaining. The decision on when to shift phases in treatment is criterion dependent for the pre-practice phase. That is, the criterion for moving to from Pre-Practice/Elicitation to Speech Motor Chaining is 6 correct productions of each variant. For clients who are readily stimulable, the elicitation of 6 correct productions of each variant may take as few as 12 attempts. For other clients, who don’t yet have the “minimal reference for correctness,” it may take more than 100 attempts or more than 1 day of therapy. Within each session, the pre-practice criterion must be met prior to moving on to Speech Motor Chaining tasks. As the client becomes more stimulable by readily producing 6 correct productions of each variant, more and more of the session will be spent in Speech Motor Chaining.



Eventually, the Pre-Practice/Elicitation may become easy for clients to complete, taking 60 – 90 seconds to obtain the criterion of 6 correct productions of each variant. When this occurs, a Random Practice block may be put on the end of the session to encourage generalization. Random practice uses the Structured Practice/Chaining stimuli. For each target, the SLP selects the MAXIMUM level at which the client was correct for 5/6 trials. At that maximum level, the client can roll a die to indicate how many times they will say the target, and the SLP can roll another die to instruct the client how to produce the target (using different prosody, like statement, question, command, slow, whisper, fast). Delayed KR feedback is provided on every other attempt – no performance-related feedback is provided.

The goals and structure of the three phases differ in several ways, as outlined below

Pre-Practice/ Elicitation Structured Practice Random Practice

Aim Acquisition of target sound through shaping, modeling strategies.

Stabilization and Learning of target sound through structured chaining opportunities that gradually increase task complexity.

Learning of target sound through random, variable practice at the highest linguistic level achieved during the session.

Type of Feedback

Knowledge of Performance

A mix of Knowledge of Performance and Knowledge of Results feedback with KP/KR occurring on most trials at lower linguistic levels, and mostly KR feedback occurring at higher linguistic levels.

Knowledge of Results

Amount of Feedback

100% of trials Fading feedback structure, with 5/6 on syllables and 3/6 at sentence level.

50% of trials.

Delay in Feedback

Immediate Feedback Mostly immediate feedback with opportunities for self-judgement on 50% of trials (to encourage self-monitoring and delay clinician feedback)

Delayed 2 – 3 seconds

(adapted from McCabe & Preston, 2016)



Relative time spent in sessions in each phase. A client who is not stimulable for correct production of a target sound (*), may start therapy on the left side of the figure and spend all (or most) of the session time in the pre-practice phase before meeting criterion, and consequently little (or no) time practicing Speech Motor Chains. A client who is somewhat stimulable for correct production of a target sound (**) may start therapy with less time in pre-practice (because it takes fewer trials to meet criterion) and more time practicing Speech Motor Chains.

* **

Pre-Practice: until 6 correct of each variant is achieved

Speech Motor Chains: for remainder of session

Random Practice: for 5 – 10 minutes

Speech Motor Chains: for the remainder of the session



INCREASING DIFFICULTY OF SPEECH MOTOR CHAINS Small adjustments to Speech Motor Chains may increase the task difficulty. Three strategies for increasing the difficulty of Speech Motor Chains are discussed below. The strategies differ from the basic Speech Motor Chains starting at the word level. The three strategies are: 1. Putting the target sequence in medial position (while still preserving syllabification); 2. Putting the target sequence in an unstressed syllable; or 3. Including competing sounds in the word/syllable

1. Medial Position. When targeting a sound sequence in initial word or word-final position, there is only one coarticulatory context. It is permissible for the client to lengthen the target sound to ensure appropriate articulation (e.g., carrrrrr). Moving the target sound sequence to medial position in multisyllabic words creates a different coarticulatory environment. This modification changes the “motor planning” requirement in the new chain. The client needs to produce the sequence correctly within the context of the multisyllabic word with appropriate timing and syllable boundaries. Most often, this is introduced with the addition of an affix (prefix or a bound morpheme suffix), although compound word contexts (e.g., 2-syllable spondees that have equal stress) can be used as well.

Syllable Monosyllabic Word Multisyllabic Word “Basic” Speech Motor Chain

Multisyllabic Word Medial Position Speech Motor Chain

/ɑr/ car pacecar carport

/ɪk/ stick broomstick sticking

/se/ sale sailor yardsale

2. Unstressed Syllable. To make multisyllabic words more challenging, the target sequences can also be moved from a stressed syllable to an unstressed syllable. Often, it is easier for clients to produce target sequences correctly in a stressed syllable. Stressed syllables are typically lengthened in comparison to unstressed syllables, and the extra length may facilitate correct movements. In unstressed syllables, the target sequences may be more challenging to the client because the movements are executed more quickly and with less transition time.


Multisyllabic Word Unstressed Syllable Speech Motor Chain

/ɑr/ car pacecar cartoon

/ɪk/ lick public pelican

/se/ sale sailor wholesale

3. Competing Sounds. The competing sounds strategy can be used at the monosyllabic word level; however, it should be introduced when the client can readily produce the target



phoneme in elicitation (e.g., around the introduction of random practice). To make monosyllabic and multisyllabic words more challenging, competing sounds or multiple targets (e.g., /l w/ for /r/ chains; /t/ for chains containing /k/) may be included in chains. Often, these competing phonemes represent the client’s error pattern; practicing words with these repeated or competing sounds may also assist increasing the difficulty.


Competing Sounds Speech Motor Chain

/ɑr/ car pacecar racecar or carwash

/ɪk/ lick public lickety split

/se/ sale sailor sailboats or sailfish

Other Modifications to Basic Speech Motor Chaining Procedures

Prosodic Variation. Numerous modifications to the chaining procedures are possible. For example, during some sessions, practice variability can be included in the form of prosodic cues. This is intended to encourage practice of the target sound sequences but with the additional requirement of varying the rate/intonation/loudness of the utterances. When prosodic variation is included, clients may practice target words, phrases or sentences slow, fast, loud, as a question, as a command, or as a statement. Although this variation was found to have only a negligible impact on learning in children with residual speech sound errors (Preston, McCabe, et a., 2014), recent research with children with childhood apraxia of speech has suggested that this prosodic variation may be beneficial to generalization and retention in that population (Preston, Maas, & Leece, submitted).

Self-Monitoring. Another modification may include explicit requirements for clients to self-rate. In our blocks of 6 trials, we have required children to self-rate on 3 of the 6 trials in each block.

A sample chain including prosodic cues and self-rating is provided below.



APPENDIX A Sample Data Sheet

An editable version of the data sheet can be also found on the lab website: http://speechproductionlab.syr.edu/Files/Data%20sheet%20template_CAS%20filled%20in.xls

Clinician_________________Participant Speech Motor Chaining DatasheetELICITATION fo or __ __ __ Elicitation for ɝl __ __ __ Block: ELICITATION fo ɛr __ __ __ Elicitation for ɝz __ __ __

SyllableFeed-back Score

Self-

Feed-back Score

Self- Multisyl. Wd

Feed-back Score

Self- Phrase

Feed-back Score

Self-

Feed-back Score

KR,KP ? KR,KP slow ?

KR,KP ? KR slow KR,KP KR,KP . KR,KP? KR,KP loud KR,KP KR,KP ! KR

KR,KP . KR,KP loud KR loud

KR,KP . ! KR slow KRKR . KR ! fast

___/6 ___/6 ___/6 ___/6 ___/6

KR,KP . KR,KP . KR,KP KR slow KRKR,KP . KR . loud

KR,KP . KR,KP ? KR,KP KR,KP fast KRSlow ? KR !

KR,KP Slow KR ! KR,KP . KR,KPKR Slow KR,KP ! KR ?

___/6 ___/6 ___/6 ___/6 ___/6

KR,KP slow KR,KP slow KR,KP KR,KP fast KR,KPslow slow KR loud KR

KR,KP slow KR ! KR,KP KR,KP ? KRKR,KP ? KR,KP ! KR slow

KR,KP ? KR,KP ? !

KR ? KR ? KR .

___/6 ___/6 ___/6 ___/6 ___/6

. . KR loud KRKR,KP . KR,KP . KR,KP ?

KR,KP . KR,KP loud KR,KP fast KRKR,KP slow KR loud KR !

KR,KP slow KR,KP ! KR,KP KR,KP . KR,KPKR slow KR ! KR slow

___/6 ___/6 ___/6 ___/6 ___/6

KR,KP ? KR,KP slow slow

KR,KP ? KR slow KR,KP KR,KP ? KRKR,KP ? KR,KP . KR,KP ! KR,KPKR,KP slow KR,KP . KR loud

slow ? KR,KP fast

KR slow KR ? KR KR . KR

___/6 ___/6 ___/6 ___/6 ___/6

KR,KP . KR,KP ! KR,KP KR,KP fast KR,KPKR,KP . ! KR,KP .

. KR slow KR KR ? KRKR,KP ? KR,KP slow KR loud

KR,KP ? KR . slow

KR ? KR,KP . KR,KP ! KR

___/6 ___/6 ___/6 ___/6 ___/6

KR,KP slow KR,KP ? KR,KP KR,KP ! KR,KPKR,KP slow ? KR,KP fast

slow KR loud KR KR slow KRKR,KP . KR,KP loud KR .

KR,KP . KR . loud

KR . KR,KP . KR,KP ? KR___/6 ___/6 ___/6 ___/6 ___/6

KR,KP ? KR,KP slow KR,KP KR,KP ! KR,KPKR,KP ? slow KR,KP fast

? KR ? KR KR ? KRKR,KP slow KR,KP ? KR loud

KR,KP slow KR ! slow

KR slow KR,KP ! KR,KP KR___/6 ___/6 ___/6 ___/6 ___/6

Gener-atedMonosyl Wd

girl

fair

gophers in the hole

x

x

early to bed

unfairly accused

gophers

early

x

bore boring boring subject x

x

x

x

xunfurl the flagunfurlfurl

floor floormatsweep the

floor

ɝz

ware warehousestocked

warehouse

hers brothersmy brother's

shoe

ɝl

unfairly

furs

or

ɛr

ɝl

ɝz

or

ɛr



APPENDIX B Theoretical Foundations & Recent Research Using Speech Motor Chaining

References Boyce, S. E. (2015). The articulatory phonetics of /r/ for residual speech errors. Seminars in Speech and Language, 36(4), 257-270. Guadagnoli, M. A., & Lee, T. D. (2004). Challenge point: A framework for conceptualizing the effects of various practice conditions in motor learning. Journal of Motor Behavior, 36(2), 212-224.

Chappell, G. E. (1973). Childhood verbal apraxia and its treatment. J Speech Hear Disord, 38(3), 362-368.

Hitchcock, E. R., & Mcallister Byun, T. (2015). Enhancing generalisation in biofeedback intervention using the challenge point framework: A case study. Clinical Linguistics & Phonetics, 29(1), 59-75. doi:doi:10.3109/02699206.2014.956232

Johnson, H. P., & Hood, S. B. (1988). Teaching chaining to unintelligible children: How to deal with open syllables. Language, Speech, and Hearing Services in the Schools, 19(2), 211-220.

Maas, E., Robin, D. A., Austermann Hula, S. N., Freedman, S. E., Wulf, G., Ballard, K. J., & Schmidt, R. A. (2008). Principles of motor learning in treatment of motor speech disorders. American Journal of Speech-Language Pathology, 17(3), 277-298. doi:10.1044/1058-0360(2008/025)

Preston, J. L., Brick, N., & Landi, N. (2013). Ultrasound biofeedback treatment for persisting childhood apraxia of speech. Am J Speech Lang Pathol, 22(4), 627-643. doi:10.1044/1058-0360(2013/12-0139)

Rvachew, S., & Brosseau-Lapré, F. (2012). Developmental phonological disorders: Foundations of clinical practice. San Diego: Plural Pub. Schmidt, R. A., & Lee, T. D. (2011). Motor control and learning: A behavioral emphasis (5 ed.). Champaign, IL: Human Kinetics.

Young, E. C. (1987). The effects of treatment on consonant cluster and weak syllable reduction processes in misarticulating children. Language, Speech, and Hearing Services in Schools, 18(1), 23-33.

Studies Utilizing Speech Motor Chaining Procedures Preston, J. L., & Leaman, M. (2014). Ultrasound visual feedback for acquired apraxia of speech: A case report. Aphasiology, 28(3), 278-295. doi:10.1080/02687038.2013.852901

Preston, J. L., Leece, M., & Maas, E. (2016). Intensive treatment with ultrasound visual feedback for speech sound errors in childhood apraxia. Frontiers in Human Neuroscience, 10(440), 440. doi:10.3389/fnhum.2016.00440 [link]

Preston, J. L., Leece, M. C., & Maas, E. (2016). Motor-based treatment with and without ultrasound feedback for residual speech sound errors. International Journal of Language & Communication Disorders. doi: 10.1111/1460-6984.12259

Preston, J. L., Maas, E., Whittle, J., Leece, M. C., & McCabe, P. (2016). Limited acquisition and generalisation of rhotics with ultrasound visual feedback in childhood apraxia. Clinical Linguistics & Phonetics, 30(3-5), 363-381. doi:10.3109/02699206.2015.1052563 [link]

Preston, J. L., McCabe, P., Rivera-Campos, A., Whittle, J. L., Landry, E., & Maas, E. (2014). Ultrasound visual feedback treatment and practice variability for residual speech sound errors. Journal of Speech, Language, and Hearing Research, 57(6), 2102-2115. doi:10.1044/2014_JSLHR-S-14-0031

Sjolie, G. M., Leece, M. C., & Preston, J. L. (2016). Acquisition, retention, and generalization of rhotics with and without ultrasound visual feedback. Journal of Communication Disorders, 64, 62-77. [link]


http://http/journal.frontiersin.org/article/10.3389/fnhum.2016.00440/abstract

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272648/

http://surface.syr.edu/etd/372/

speech motor chaining procedures - speech production …speechproductionlab.syr.edu/_pdfs/chaining...

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