INTERVENTION STRATEGIES

1
INTERVENTION STRATEGIES ACTIVITIES for
PRESCHOOLERS with SPEECH SOUND DISORDERSNancy
Creaghead Barbara Hodson ASHA Annual
ConventionNovember 16, 2006 PART
1--INTERVENTION for PRESCHOOLERS with HIGHLY
UNINTELLIGIBLE SPEECHBarbara W. Hodson, PhD,
CCC-SLPbarbara.hodson_at_wichita.edu
2
CHILDREN with HIGHLY UNINTELLIGIBLE
SPEECH-SOME CONCERNS

• Critical Age Hypothesis 56 Bishop Adams
• Matthew Effects Stanovich
• Later Years--Some Common Difficulties
• Reading Comprehension Fluency
• Spelling Writing
• Multisyllabicity
• Imprecise Speech Subtle Errors
• Word Finding

3
SEVERITY CONTINUUMNote Distortions
Assimilations may occur at all levels, but
Distortions more common for Mild/Moderate
Unexpected Assimilations Common for
Severe/Profound

• _________________________
• Profound
• EXTENSIVE Omissions
• Many Substitutions
• Extremely Limited Repertoires
• ______________________________
• Moderate
• Some Omissions
• Some Substitutions
• ________________________________

• _______________________
• Severe
• Many Omissions
• EXTENSIVE Substitutions
• Limited Repertoires
• ___________________________
• Mild
• Omissions Rare
• Few Substitutions

______________________________
4
TYPICAL PERFORMANCE3-7 Years

• 3-5 Years
• Syllable Structures
• Omissions Rare by age 4 yrs
• e.g., Final Consonants (by age 2)
• /s/ Clusters (by age 3, but /s/ may be
  distorted)
• Few Simplifications
• Most (e.g., Fronting) Eliminated
• Intelligibility gt 90
• Adult-like Speech

• 5-7 Years
• Phonemic Inventory
• Completed
• Liquids 4-6 years
• th by age 7
• Phonetic Distortions
• e.g., Lisps- Eliminated by age 7
• Multisyllabicity
• Adult-standard
  

5
MAJOR OPTIONS for TREATMENT

• Emphasis on Phonemes
• Traditional Van Riper
• Least Phonological Knowledge Elbert Gierut
• Maximal Oppositions Gierut
• Multiple Oppositions Williams
• Oral Motor Exercises e.g., Marshalla
• Whole Language Hoffman, Norris, Monjure
• Phonological Awareness Gillon
• Phonological PATTERNS Including Minimal Pairs
  (Fairbanks) that Contrast childs actual
  deviations

6
POTENTIAL OPTIMAL PRIMARY PHONOLOGICAL TARGET
PATTERNSfor BEGINNING CYCLES

• Target only those that are CONSISTENT
  deviations. Targets must be STIMULABLE, however
  otherwise would reinforce inaccurate kinesthetic
  image
• Word/Syllable Structures OMITTED Phoneme
  Segments
• Syllableness i.e., number of
  vowels/diphthongs
• Compound Words e.g., cowboy, baseball
• 3-syllable/word combinations e.g., cowboy hat,
  baseball bat
• Singleton Consonants Syllable/Word Structure
• CV word-initial /p,b,m,w/ if lacking
• VC voiceless final Stops /p, t, k/ final
  /m,n/ if lacking
• VCV e.g., apple
• /s/ Clusters for omissions, not
  substitutions/distortions
• Word-initial e.g., /sp/, /st/, /sm/, /sn/
• Word-final e.g., /ts/, /ps/
• Incorporate phrase Its a /s/ cluster word
  after child demonstrates facility producing

7
PRIMARY TARGETS-2 for BEGINNING CYCLES

• Anterior/Posterior Contrasts when stimulable
• Velars if Fronter
• Word-final /k/
• Word-initial /k,g/ occasionally /h/
• Alveolars/Labials if Backer
• Facilitation of Liquids even if not
  stimulable
• Word-Initial /l/ preceded by week of tongue-tip
  clicking
• Word-Initial /r/ suppress gliding initially
• Exaggerate vowel
• Do not blend initially
• Incorporate /kr/, /gr/ when child has
  velars--typically 3rd cycle

8
GENERAL COMMENTSRegarding Targets

• Approximately 60 mn per PHONEME target
• At least 2 phonemes per target PATTERN
• Reassess phonology between cycles
• Recycle Primary Patterns as needed
• until begin to emerge in conversation
• Proceed to Secondary Patterns after
• Early developing patterns established
• /s/ clusters emerging in conversation
• Contrastive use of Velars Alveolars
• Practice words for Liquids-produced without Glide

9
POTENTIAL SECONDARY TARGETS

• Target Any of the Following that are still
  Consistently Lacking/Deficient
• Palatals
• Singleton Stridents
• Other Consonant Sequences
• Vowel Contrasts
• Voicing Contrasts
• Assimilations
• Any Remaining Idiosyncratic Patterns
• Minimal Pair Words especially useful for these

10
INAPPROPRIATE TARGETS for PRESCHOOLERS

• Dont target aspects that phonologically normal
  peers dont actually produce
• Word-final Voiced Obstruents e.g., /b,d,g,z/
• Unstressed weak Syllables e.g., refrigerator
• th e.g., mouth
• ng e.g., going
• Vocalic /l/ e.g., ball
• Note Sibilants are appropriate targets for
  preschoolers only if stridency is lacking e.g.,
  /t/ for /s/ /s/ cluster reduction, but NOT for
  LISPS which maintain stridency and do not have a
  particularly adverse effect on intelligibility.

11
TREATMENT SESSION-BASIC STRUCTURE

• Review last sessions practice words
• Listening activity approximately 30 seconds
• 15-20 words containing target NOT carefully
  selected
• Child must not repeat these words
• Slight amplification
• Production-practice words 5-6 carefully
  selected
• Activities for eliciting productions
• use cues/assists/models as needed Goal is 100
• child takes turn after saying target
  correctly in production-practice word change
  activities every 7 or 8 minutes
• Metaphonological Activity e.g., rhyming
• Probe for next sessions target
• Repeat listening activity with slight
  amplification
• Home practice 2 minutes per day

12
CLIENT EXAMPLEAge 3515 yearsmonthsdays

• HISTORY
• Upper SES home
• One younger sibling toddler
• Health/Physical History Unremarkable
• except for congestion upper respiratory
  infections
• Receptive Language-Superior
• Adenoidectomy PE tubes age 39

13
CLIENTs PHONOLOGICAL ASSESSMENTPRETREATMENT
SCORES OMISSIONS

• Phonological Deviations Occurrence
  Percentages
• Syllables 0
• Consonant Clusters/Sequences 118
• Consonant Singletons
• Prevocalic 0
• Intervocalic 7
• Postvocalic 100
• Hodson Assessment of Phonological Patterns
  (HAPP-3 2004)

14
PRETREATMENT SCORES-2CONSONANT CATEGORY
DEFICIENCIES

• Phonological Deviations
  Occurrence Percentages
• Sonorants
• Liquids 100
• Nasals 76
• Glides 60
• Obstruents
• Stridents 100
• Velars 100
• Other Anterior Nonstridents/Backing 33
• Total Occurrences of Major Phonological
  Deviations TOMPD 195
• Pretreatment Severity Interval Rating High
  Profound
• HAPP-3 TOMPD Severity Intervals 1-50 Mild
  51-100 Moderate 101-150 Severe gt150
  Profound (Top 10 pts-High Bottom 10-Low)

15
PRETREATMENT SCORES-3STRATEGIES
SUBSTITUTIONS/ASSIMILATIONS

• Occurrences
• Vowel Deviations 31
• Stopping 16
• Fronting 12
• Gliding 12
• Reduplication 10
• Labial Assimilation 7

16
PHONETIC PHONOTACTIC INVENTORIES PCC

• Consonants
• /p/, /b/
• /t/, /d/
• /m/, /n/
• /w/, /j/
• Syllable Structures
• CV and Reduplications of CVs
• No Final Consonants
• No Consonant Clusters
• Percentage of Consonants Correct Shriberg
  Kwiatkowski PCC 10

17
STIMULABILITY CONSIDERATIONS GOAL STATEMENT

• Stimulable with assists (i.e., models, tactile
  cues, amplification) at time of initial
  assessment Age 36 for
• Final C /p/ /t/
• /s/ Clusters word-initial /sp/, /st/, /sm/,
  /sn/
• Not Stimulable initially for
• Velars
• Liquids
• Goal Statement for Beginning Cycles
• Enhance the following phonological patterns
  to expedite intelligibility gains
• (a) Final Consonants
• (b) /s/ Clusters Stridents Consonant
  Clusters
• (c) Velars when stimulable
• (d) Liquids

18
CLIENTS PHONOLOGICAL TARGETS for CYCLE-ONE

• Word-Final C /p/ /t/ 1 hour each per
  semicolon
• /s/ Clusters
• Word-Initial /sp/ /st/
• Word-Final /ts/ /ps/
• Velars Word-Final /k/ 7 sessions/hours
• Summer Break--May to SeptNo Phonology
  Clinic Available
• Word-Initial /k/ /g/
• /s/ Clusters /sn/ /sm/ /sk/ recycled
  /sp/ /st/
• Liquids /l/ /r/ /kr/ 10 sessions
• Also facilitated/stimulated /h/ without actually
  targeting it
• Cycle-One Total Sessions/Contact Hours
  17

19
CYCLE-TWO TARGETS

• /s/ Clusters /sp/ /st/ /sm/ /sn/ /sk/
• Liquids /l/ /r/ /kr/ /gr/
• Recycled all /s/ clusters
• Added Its a ____ phrase 2 sessions
• Other CCs Secondary Patterns
• /kw/ /kj/ e.g., queen, Q
• Medial /st/ e.g., toaster
• Final /st/ e.g., nest
• Cycle-Two Total Sessions/Hours 13

20
CLIENTS ADDITIONAL TARGETS forCYCLES THREE
FOUR

• Liquids
• Palatal Sibilants
• Consonant Clusters/Sequences
• Medial Final /s/ Clusters e.g., basket, desk
• Glide Clusters e.g., cube, queen
• /r/ Clusters e.g., /kr, gr, tr, dr/
• CCC 3-Consonant Clusters, e.g., /skr/
• Cycle Three-13 sessions Cycle Four-9
  sessions
• Total for Cycles Three Four 22 Sessions/Hours

21
PRE-, INTERIM, POST-TREATMENT DATA/OUTCOMES

• 36 47 57
• Cons. Seq. 118 62 18
• Post. Sing. 100 0 0
• Stridents 100 10 5
• Velars 100 50 5
• Liquids 100 100 95
• TOMPD 195 65 30
• Severity Hi-Profound Moderate Mild
• Intelligibility 5 65 90
• - - - - - - - - - - - - - - - - - - - - - - - - -
  - - - - - - - - -
• 30 hrs 22hrs 52 Contact
  Hrs across 25 months
• Hodson Computerized Analysis of Phonological
  Patterns (2003)

22
PRODUCTIONS/TRANSCRIPTIONS OVER TIME

• Chronological Age
• Stimulus 36 42 47 57
• basket bApc bQjI bQsIt bQskIt
• cowboy hat tAtcA taUbehQt kaUbehQt kaUbIhQt
• glasses dAtU dQjI dQtIs gwQsIz
• hanger jojc heNgU heNU heNU
• ice cubes Apu aItup aItups aIskjubz
• music box mowIbA mudibAk musIbAks mjusIkbAks
• smoke po moUk smoUk smoUk
• soap po toUp soUp soUp

23
Total Occurrences of Major Phonological
Deviations TOMPDAges 36 to 57
24
MAJOR RECOMMENDATIONSExpressive Phonology

• Identify Consistent Broad Deviations
• Determine Priorities Clients, Time,
  Individual/Group
• Select Optimal Targets Patterns, Phonemes,
  Words
• Increase Complexity Gradually
• Facilitate Development of Awareness
• Auditory, Kinesthetic, Semantic
• Incorporate
• Slight Amplification a few minutes as needed
• Tactile Cues as needed
• Models particularly for new target
• Enhance Metaphonological Skills
• Develop Precise Phonological Representations see
  Mody Stackhouse

25
GENERAL RECOMMENDATIONS for CHILDREN with HIGHLY
UNINTELLIGIBLE SPEECH

• Early Intervention-Critical
• Individualize Treatment
• Evidence-based Practices/Documentation
• Enhancement of PATTERNS

26

• ENHANCE
• PATTERNS
• PHONOLOGICAL
• METAPHONOLOGICAL

27
Appendix ASELECTING OPTIMAL PRODUCTION-PRACTICE
WORDS for BEGINNING CYCLES

• Monosyllabic Words Real
• Facilitative Phonetic Environment (Kent)
• Words in Childs Lexicon
• Avoid selecting words with consonant at same
  place of articulation as substitute
• e.g., NOT cat, coat, can, kiss, corn, candy,
  gas, goat,
• gate, gun, sock, tack, dog (if substituting
  /t/ for /k/ /d/ for /g/)
• e.g., NOT rope, robe, row, room, roof, rabbit
  leaf, lamb, lamp, lip, loop, laugh (if
  substituting /w/ for /l/, /r/)

28
Appendix BSOME SUGGESTIONS for ELICITING SOUNDS

• Final C e.g., final /p/-pop lips puff of air
• /s/ Clusters Draw finger along arm for /s/ and
  tap for the 2nd consonant for initial /s/
  clusters
• Velars Tap throat for /k/ to indicate
  backness
• sometimes use dum dum sucker to stimulate
  back of tongue
• occasionally model velar fricative /x/
• Liquids
• /l/ tongue tip clicking independent of jaw--1
  week before
• /r/-open mouth as wide as possible
  emphasize/prolong vowel do not blend during
  initial cycles Eliminate /w/ first
• Palatal Sibilants /s/ plus /j/ for sh (e.g.,
  missyou)
• /t/ /s/ /j/ for ch /d/ /z/ /j/ for
  j
• Reminder Amplification often helps child

29
SOME SELECTED REFERENCES-Books/Special Issues

• ASHA Monograph (1994). Childrens phonology
  disorders Pathways and patterns.
• Bernthal, J., Bankson, N. (2004). Articulation
  and phonological disorders.
• Bleile, K. (2004). Manual of articulation and
  phonological disorders.
• Gillon, G. (2004). Phonological awareness From
  research to practice.
• Hodson, B. (Ed.) (1994). From phonology to
  metaphonology Issues, assessment, and
  intervention. Topics in Language Disorders.
• Hodson, B. (2007). Evaluating and enhancing
  childrens phonological systems From research
  and theory to practice.
• Hodson, B., Edwards, M. (Eds.) (1997).
  Perspectives in applied phonology.
• Hodson, B., Paden, E. (1983, 1991). Targeting
  intelligible speech A phonological approach to
  remediation.
• Kent, R. (Ed.) (2004). The MIT encyclopedia of
  communication disorders.
• Stackhouse, J., Wells, B. (1997, 2001, 2006).
  Childrens speech and literacy difficulties (I,
  II, III).

30
SOME SELECTED REFERENCES-Articles/Chapters

• Forrest, K. (2002). Are oral-motor exercises
  useful in the treatment of phonological/articulato
  ry disorders? Seminars in Speech and Language.
• Gordon-Brannan Hodson (2000).
  Intelligibility/severity measurements of
  prekindergarten childrens speech. AJSLP.
• Hodson, B. (1994). Helping children become
  intelligible, literate, and articulate The role
  of phonology. Topics in Language Disorders
• Hodson, B. (1997). Disordered phonologies What
  have we learned about assessment and treatment?
  Perspectives in applied phonology.
• Hodson, Scherz, Strattman (2002). Evaluating
  communicative abilities of a highly
  unintelligible preschooler. AJSLP.
• Hodson Strattman (2004). Phonological awareness
  intervention for children with expressive
  phonological impairments. The MIT Encyclopedia of
  Communication Disorders.
• Nathan, Stackhouse, Goulandris, Snowling
  (2004). The development of early literacy skills
  among children with speech difficulties. JSLHR.
• Porter Hodson (2001). Collaborating to obtain
  phonological acquisition data for local schools.
  LSHSS.

31
Intervention Strategies and Activities for
Preschoolers with Speech Sound
DisordersClassroom Intervention Nancy
CreagheadUniversity of Cincinnati
32
Questions to Consider

• Can/should we work on phonology in the preschool
  classroom?
• Can/should work on phonology and language be
  combined?
• Does the childs severity level affect these
  decisions?
• What is the evidence?

33
Relationship between Language and Phonology

• It has been found that
• Children with phonological disorders are more
  likely to have language disorders.
• Children with language disorders are more likely
  to have phonological disorders
• There is an obvious synergistic relationship
  between the two phonology is an aspect of
  language!
• Current theories of language and phonologic
  acquisition support this relationship.

34
Assumptions about Intervention

• Does work on phonology help language skills?
• Does work on language skills help phonology?
• Where is it best to target phonology?
• In individual phonological therapy?
• Concurrently with language therapy?
• In naturalistic environments e.g. the classroom?

35
Treatment Strategies

• Phonology treatment only
• Language treatment only
• Sequential phonology and language treatment
• Simultaneous language and phonology treatment -
  non integrated
• Integrated phonology and language treatment

36
Implications for Treatment

• The possibilities to consider are
• There is generalization across phonology and
  other language domains
• There is no generalization across domains
• There is generalization only in one direction,
  i.e. from phonology to other language domain only
  or from other language domains to phonology only.

37
Generalization from language-based intervention
to phonologic domain

• Hoffman et al.(1990)
• 2 children treated by
• Minimal pairs for phonology OR
• Story retell for language
• Both children made gains in phonology. Child
  with phonology treatment made slightly greater
  gains
• Child with language treatment made language
  gains, but child with phonology treatment did not
  make significant language gains
• Tyler et al. (2002)
• 20 children treated for morphosyntax and
  phonology in different consecutive orders
• Children who received morphosyntax first
  performed as well as those who had phonology
  first.
• Suggests consideration of treatment of
  morphosyntax first
• Hoffman (1996)

38
Little generalization from language to phonology

• Tyler and Sandoval (1994)
• Six preschoolers with both language and speech
  sounds disorders
• received intervention on language (focused
  stimulation of narratives), phonology (modified
  cycles elicited imitation and minimal pairs) or
  both
• Some generalization from phonology to language
• Negligible generalization for language to
  phonology
• Children who received combined approach made
  greatest gains in both.
• Tyler Waterson ( 1991)

39
Little generalization from language to phonology

• Fey et al. (1994)
• 26 children in moderate to profound range for
  speech sound disorders
• Treated grammar, e.g.
• Focus on will for future time
• Focus on are as aux and copula
• Focus on is as aux and copula
• Focus on combining sentences with and, but
• No direct effects on phonology

40
Evidence to date is not conclusive.Possible
Explanations for Discrepancies among Studies

• Differences in
• Research methodology
• Duration of treatment programs
• Treatment methods
• Severity of impairments across studies
• Importance of childs ability to make the sound

41
Phonological Awareness and Reading Problems

• Research indicates that
• Children with reading problems often have
  difficulty with segmentation.
• Sound segmentation ability in kindergarten is a
  strong predictor of later reading ability.
• Sound segmentation may be a necessary
  prerequisite for reading.
• Ability to read may improve sound segmentation.

42
Relationship between Phonological Awareness and
Speech Sound Disorders

• Webster and Plante (1992) k-2
• Children with normal phonology scored higher than
  children with speech sounds disorders on 3 of 4
  phonological awareness tasks
• Performance was correlated with intelligibility
• Cowan and Moran (1997) k-2
• Children with mild speech sound disorders scored
  lower than typical children on the 3 tests.
• Performance was not related to specific sound
  errors
• Children with accompanying language problems did
  not perform more poorly than children without.
• BUT some children with speech sounds errors
  performed better than the typical children.
• Severity may be an important factor

43
Implications regarding Phonological Awareness

• Improvement of phonological production?
• Improvement of phonological awareness?
• Combination of intervention/instruction?

44
Treatment Approaches for Speech Sound Disorders

• Contrast training
• Minimal pair opposition
• Maximal pair opposition
• Selected word practice
• Seizing the moment
• Using books
• Using the curriculum
• Intervening during play

45
We have to consider the treatment issues when we
plan Phonologic Treatment in Naturalistic
Settings for example

• Patterns/process selection
• Sound/word target selection
• Stimulability
• Facilitating contexts
• Intelligibility
• Frequency of occurrence of the sound
• Developmental appropriateness
• Phonological knowledge

46
PRINCIPLES OF LANGUAGE LEARNING

• Children learn language by learning at least four
  sets of rules pragmatic, semantic,
  syntactic,phonologic/graphic.
• The language learning process is self-regulated
  by each child. The child must be cognitively
  ready for the language function, meaning and
  structure.
• Children learn language in appropriate contexts
  which are experientially based and meaningful for
  them.
• Children learn language when they have a reason
  to communicate.

47
PRINCIPLES FOR LANGUAGE "TEACHING"

• The content for language teaching must be
  meaningful and relevant to the child and
  sequentially based on normal development.
• Pacing must be at the child's own speed.
• Sequencing of skills should consider typical
  development.
• Careful observation of each child will allow the
  child to help us choose meaningful goals.
• The best motivator is natural reinforcement for
  successful communication.

48
PRINCIPLES FOR LANGUAGE "TEACHING"

• The context for language teaching should
• be based on the child's level of cognitive
  development
• draw from the child's natural environment
• involve interpersonal interaction
• involve active participation on the part of the
  child
• be larger than life.

49
Remediation Based on Normal Development

• The acquisition of phonemes and phonological
  rules is not an all-or-non process. accuracy
  comes gradually and not for one sound at a time.
• All exemplars of a phoneme do not have to be
  practiced for acquisition to occur
• Treatment of multiple error patterns in preschool
  children presents different issues than treatment
  of older children who have errors on only /r/ or
  /s/.
• There are advantages to working with children in
  groups.
• Like other language rules, phonological rules are
  learned through the process of communication in
  natural and meaningful contexts.

50
Implications for Serving Preschool Children

• The preschool classroom provides a natural and
  meaningful context where communication is
  required.
• Every child does not have to work on only one
  sound that is chosen as his target. Modeling and
  practice of a variety of sounds can occur and is
  in keeping with normal acquisition.
• Naturally occurring words can be used for
  practice words.
• Modeling, exposure and the opportunity for
  practice can be provided.
• Children can learn from each other and can be
  encouraged to try when other children participate.

51
Evidence for Classroom Based InterventionMontgome
ry, J., Bonderman, I. (1989) Serving preschool
children with severe phonological disorders.
LSHSS, 20, 76-84.

• 9 children with severe or profound ratings
• Preschool class directed toward phonological
  intervention followed Hodsons Cycles Approach
• Direct treatment followed Hodsons approach
• Snack and break included sound monitoring
• 5-minute home program each day
• Children attended 3 days/week for 2 hours for 2
  two-month periods separated by summer break (17
  weeks/50 days)

52
Evidence for Classroom Based InterventionMontgome
ry, J., Bonderman, I. (1989) Serving preschool
children with severe phonological disorders.
LSHSS, 20, 76-84.

• All children decreased severity levels either 1
  or 2 levels
• Four children were dismissed from services.
• No children met preschool eligibility
  requirements at the end of the program.
• The child with least progress missed 17 days

53
Montgomery Bonderman (1989) TargetsSession One

• Week Phonological Patterns
• 1 Singleton Final Consonants
• 2 Stridency
• 3 Stridency Consonant Clusters
• 4 Velars
• 5 Liquids
• 6 Liquids
• 7 Stridency CC
• 8 Stridency CC

• Phoneme Targets
• word-final /p/,/t/,/k/
• word-final /ts/,/ps/,/ks/
• word-initial /sp/,/st/,/sn/
• word-final /k/
• word-initial /k/,/g/
• word-initial /1/(2 days)
• word-final /?/
• word-final /?/
• word-initial /r/ (2 days)
• word-final /ts/,/ps/,/ks/
• word-initial /sp//st/
• word-initial /sm//sn/
• word-initial /sp/,/st/,/sm/,/sn/

54
Our Preschool Phonology Group

• Traditional preschool classroom setup and
  schedule 4 6 children
• Two days per week, 2 hours per day
• Opening group calendar, songs, poems, books
• Craft activity
• Snack
• Free play

55
Our Preschool Phonology Group

• Modified cycles approach to targeting patterns
  for whole group
• Pattern changed weekly
• Patterns/sounds targeted within classroom theme
  and activities
• Entire classroom designed to elicit target sounds
• Stories/books modified or created to include
  target sounds

56
Target FricativesTheme At the Beach

• Books
• Rainbow Fish
• Rainbow Fish Lost at Sea
• Rainbow Fish to the Rescue
• At the Ocean
• The Ocean Alphabet
• Sand/Water Table
• Sand, seashells, shells, salt water,
  same/different, fish, swim, swish,
• Craft
• Painting seashells, brush
• Snack
• Fish, sand dollar cookies, seaweed slaw

57
Including Phonology in the Preschool Classroom

• Calendar
• /k/ calendar, cold, week
• /s/ sunny, summer, snow
• /r/ rain, September, year
• /f/ Friday, February, fair
• Songs/poems
• /k/ Five Little Monkeys
• /s/ Itsy Bitsy Spider, The Wheels on the Bus
• /r/ Row, Row, Row Your Boat, The Wheels on the
  Bus
• /f/ Five Little Monkeys

58

• Play activities
• /k/ cars and trucks, blocks
• /s/ sand table, school
• /r/ rolling the ball, rocking the baby, making a
  road
• /f/ farm football
• Arts and crafts activities
• /k/ crayons
• /s/ scissors
• /r/ rock painting
• /f/ finger painting

59

• Snacks
• /k/ popcorn
• /s/ juice
• /r/ raisins
• /f/ fruit
• Book reading
• /k/ The Very Hungry Caterpillar (Carle)
• /s/ Cinderella
• /r/ Are You My Mother (Eastman)
• /f/ Find My Blanket (Brady)

60
Velar Opportunities for Going on a Picnic

• Carrots
• Cake
• Candy
• Cookies
• Coolade
• Ice cream
• Coke

• Picnic
• Milk
• Bake
• Take
• Like
• Sack
• Back pack

61
Phonologic Treatment in Preschool Settings

• Response to Intervention
• (Speech Improvement?)
• Providing a strong curriculum for all children
• Providing targeted instruction in the classroom
  for at risk children
• Providing an intervention
• program to reduce the
• number of identified
• children

62
References

• Masterson, J. (1993). Classroom-based
  phonological intervention. American Journal of
  Speech-Language Pathology, 2, 5-9.
• Schlosser, K. G., Phillips, V. L. Building
  literacy with interactive language charts.
  Scholastic Inc.
• Warren, J. The piggyback song book series. Waren
  Publishing House Inc.