The Role of Speech P erception - PowerPoint Presentation

Slide1

The Role of Speech Perception Training in Phonological Intervention

Bronwyn Carrigg & Elise Baker on behalf of

EBP Paediatric Speech Group 2011

NSW Speech Pathology EBP Network

What is Speech Perception? Where does it fit? Phonological Processing: broader term describing the use

of phonological information to process spoken and written

language (

incl

PA,

Phon

Working Memory,

Phon

Retrieval)

Speech Perception and Phonological Awareness

: comprise

different aspects of phonological processing. In speech

perception tasks (such as mispronunciation detection),

child does not have to segment words into smaller units,

as required in PA tasks.

Speech Perception: continuous acoustic signal -> discrete linguistic unitmost models assume a multistage process by which

Acoustic Signal -> Phonetic Units -> Phonological Rep

depends on detailed acoustic-phonetic representations

word/sound identification tasks (point to ‘shoe’ or X)

Phonological Awareness (PA)

:

depends on segmented phonological representations

conscious awareness of sound structure of words

matching & manipulating sound structures

eg

syllables

appears to be core deficit in SLI, SSD, Dyslexia*

(

Rvachew

&

Grawburg

, 2006; *

Snowling

et al 2000 cited in

Rvachew.S

. 2006)

Speech Perception & Phonological Awareness are related;

half sample with SSD had poor speech perception & PA

speech perception is pivotal in PA emergence

speech perception & receptive vocab jointly predicted PA

speech perception & receptive vocab->PA->emergent lit

articulation accuracy did not predict PA

reciprocal relationship (PA<->vocab; PA<->

emerg

literacy

Caution…half sample had adequate speech perception & PA

(

Rvachew

&

Grawburg

, 2006, 95 preschoolers with SSD with normal comp)

Development of clinical question

Decided to focus on;

Role of speech perception tasks rather than PA tasks in Rx

Studies comparing Perception + Production

vs

Production Rx

Studies using SAILS speech perception program (multiple speakers producing normal and misarticulated versions of tgt) PICO Clinical Question:

In children with phonological impairment does the SAILS

speech perception program plus production training

compared with

production training alone

lead to better speech production outcomes? (x4 studies)

Rvachew, S (1994) Speech perception training can facilitate sound production learning. JSHR, 37, 2, p.347

Speech Perception + Production

vs

Production only

27 children mod-severe SSD, 3 groups, 6 sessions,

unstimulable

/sh/60 production trials/session. 60 speech perception trials/session

Group 1

: perception task = correct/incorrect versions of ‘shoe’

Group 2

: perception task = listened to ‘shoe’

vs

‘moo’

Group 3

: control group, no perception task but computer game.

Conclusion

: Overall, children receiving Perception + Production Rx

made greater speech improvement than Production Only group on

non-

stimulable

sounds

Speech Perception + Production vs

Production only

Group 1

: n=10, 9 group Rx sessions cycles (

incl

audit bombardment)

Group 2: n=13, 6 group Rx sessions cycles (incl audit bombardment) plus 3 individual Rx (stimulability & perception SAILS)

Conclusion

: Group who received speech perception +

stimulability

+ production training made more gains than production only group, especially on non-stimulable or poorly perceived sounds

Rvachew

,

Rafaat

, Martin (1999)

Stimulability

, speech

perception skills and the treatment of phonological disorders AJSLP, 8, 33-43

Wolfe, Presley, Mesaris (2003) The importance of Sound Identification Training in Phonological intervention, AJSLP,

Speech Perception + Production

vs

Production only

2 treatment groups (n=4, n=5), PSK severe SSD, 11 sessions

Group 1

: Production only Rx

Group 2

: Production + Speech Perception Rx

Conclusion

: on speech error sounds that were stimulable pre-RxWell identified/perceived errors (pre-Rx) – No differencePoorly identified/perceived errors (pre-Rx) – Mixed betterProduction only training improved perception

Rvachew, Nowak et al (2004) Effect of phonemic perception training on speech production and phonological awareness skills of children with expressive phonological delay. AJSLP, 13, 250-263

Speech Perception + PA + Production

vs

Production only

n=34, PSK, mod-severe SSD, mean Rx 12 sessions, ++ variability in Rx

Group 1

: Production and *Perception (16x15 min sessions SAILS)

Group 2

: Production only (16x15 min sessions computerised book)

*Perception Rx included generic phonemic perception, plus letter

recognition, sound symbol ass, onset/rime matching (ie PA)Conclusion

: Mixed Rx (

Perception+PA+Production

) led to greater

gains in speech production and perception than production only group

No differences in PA between groups.

Clinical Bottom Line:

In preschool children with SSD with speech perception difficulties;

the evidence suggests that speech perception training, specifically

the SAILS program, plus production training is more effective at

improving production of

stimulable

and non stimulable speechsounds than production only training.

Production Only treatment also improves speech perception

Guidelines for combining speech perception training with production practise: Authors caution that;

perception Rx should always be concurrent with production Rx;

production training should be explicit,

ie

including cues/prompts

speech perception contrasts match contrasts for production Rx

speech perception exercises based on child’s sound errors may start with maximum distinctions later moving to finer distinctionsSpeech perception, like stimulability, may provide information about

underlying phonological knowledge; and may be useful to consider in

selecting targets, predicting progress, as well as in treatment

.

Problem: SAILS is for North-American speakers...

POSSIBLE WAYS FORWARD...

Australian adaptation of SAILS being investigated – with Australian speakers of different ages, genders (contact: Elise Baker if interested).

Alternate suggestion in the meantime– provided ‘modified’ SAILS, using various people in the child’s environment:

clinician, parents, siblings, grandparents

The variety of speakers would provide the child with opportunities to better refine the child’s underlying representation.

Need to collected INTERNAL clinical evidence from everyday practice, to determine whether this ‘modification’ would still be beneficial.

Current Topic: Treatment in CASQuestion 1: In children with Childhood

Apraxia

of Speech does Dynamic Temporal and Tactile

Cueing (DTTC) lead to an improvement in

speech production.

References

Rvachew

, S (1994) Speech perception training can facilitate sound production

learning.

JSHR

, 37, 2, p.347

Rvachew, S (1994) Speech Assessment and Interactive Learning System; SAILS; AVAAZ InnovationsRvachew, Rafaat, Martin (1999) Stimulability, speech perception skills and the treatment of phonological disorders.

AJSLP

, 8, 33-43

Wolfe, Presley,

Mesaris (2003) The importance of Sound Identification Training in Phonological intervention, AJSLP, 282-288Rvachew, Nowak et al (2004) Effect of phonemic perception training on speech production and phonological awareness skills of children with expressive

phonological delay.

AJSLP

, 13, 250-263

Rvachew

, S (2006) Longitudinal Predictors of Implicit Phonological Awareness

Skills,

AJSLP

, 15, 165–176

Thank you to EBP Paed Speech members; SWAHS, SSWAHS,

HNEAHS, SESIAHS, NSCCAHS

University

of Sydney, Private

SPs, Learning

Links

To join contact;bronwyn.carrigg@sesiahs.health.nsw.gov.au