Question
For nine months, I have been working with a nonverbal nine year old child with Down Syndrome in a self contained-collaborative classroom. Though I can see where the student makes attempts to imitate, her attempts often resemble the sounds of deaf speech.
Answer
We recognize patients' rights to make decisions about their treatment. However, parents of clients can be very demanding relative to directing their child's treatment, even to the point of dictating the type of treatment and the intervention strategies and materials. We have to educate parents and clients about various evidence-based practices and provide justification for our clinical decisions. Ethically, we cannot deliver inappropriate treatment nor withhold treatment that is appropriate for the client.
With that said, consider promoting the child's speech production within a functional communication framework of language-literacy materials and strategies. Speech sounds can be introduced and elicited within the framework of a story. Select literature that has repetitive speech sounds within simple sentence structures. These stories are predictable and help the child learn the structures of language. Stories that contain large, colorful pictures would hold the developmentally young client's attention and be appropriate to the child's cognitive and linguistic levels of development. Children love to listen to stories about animals, fantasy creatures and heroes. Themes and motor and dramatic play activities can be developed based on a story or series of stories. There are many resources on line and in language and reading textbooks.
You could look at these sites for some suggestions:
Scaffolding strategies (Norris & Hoffman) can be utilized during the literature-based activities to emphasize functional communication within a natural learning exchange. The materials help develop the child's preliteracy, language, and speech skills. Phonic Faces (Norris) could also be used to help the client see the differences between the printed symbol and the spoken sound. Information from the Phonic Faces web site (www.elementory.com/speecpatphon.html) explains that Phonic Faces picture the articulation of sounds. The child uses the visual depiction of the sound, as it is pictured on a face to imitate or produce the correct sound, place the sound in the correct position within words, and generalize the sound to other words. By using the faces in literacy intervention activities, the child develops speech, language, and literacy skills within a contextual language environment.
Dr. Paula S. Currie is a certified speech-language pathologist with more than 25 years of clinical and teaching experience. She has worked with in a variety of settings, and an area of special interest includes language-literacy development and disorders. Dr. Currie is the Head of the speech-language pathology program at Southeastern Louisiana University.
Margaret Fish, MS, CCC-SLP
Margaret is a speech-language pathologist working in private practice in Highland Park, Illinois, with over 30 years experience as a pediatric SLP. Her primary professional interests are in the areas of children’s speech sound disorders, language disorders, and social language development. Margaret is the author of the book, Here’s How to Treat Childhood Apraxia of Speech, now in its Second Edition. She is a frequently invited speaker at local, state, and national workshops. Her workshops and writing focus on providing practical, evidence-based ideas to support clinicians working with children with CAS. Margaret serves on the Professional Advisory Board for the Childhood Apraxia of Speech Association of North America (CASANA) and is a topic area advisor for the SpeechPathology.com Advisory Board.
Related Courses
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'Assessing students with AAC for a language disorder at an advanced level isn't something I've often thought of due to the population I usually serve'Read Reviews
This is Part 4 of the 5-part series, Applying the Science of Reading, Writing, and Oral Language for Students Who Use AAC. Improving the linguistic foundation of students who use AAC supports the development of strong literacy skills. Key intervention strategies and guidelines for robust language intervention for AAC users are discussed along with examples demonstrating their application to various language skills.
