Kathy Kendrick SLPA 216/218 Fieldwork Practicum Treatment Plan 3 2-22-2011

3.1 3.2 3.3 3.4

Pediatric Apraxia Treatment Plan Adol/Adult Apraxia Treatment Plan Pediatric Dysarthria Treatment Plan Adol/Adult Dysarthria Treatment Plan

TREATMENT PLAN 3.1 PEDIATRIC Apraxia

Target Population: Pre-school: Age 3
1.

Objectives: This session is intended to offer maximal practice of motor-learning activities for basic speech production of /p^/, /t^/, /k^/ for a young child. Research has shown that for Apraxia, therapy is best if it is frequent and intensive. In addition, group therapy is not recommended. This lesson plan is for an individual session, lasting 20 minutes, and the child is to be seen 4 times per week.

2. Pre-practice/ Introduction: Good morning! I m so glad to see you today! We are going to get started right away today. Pick a picture and a color. Do you want a butterfly or a fish? Do you want red or blue? 3. Purpose: For our speech class today we are going to continue to work on our /p^t^k^/ sounds. I will say it and you copy me. Let s get started. 4. Motivation: While we practice you can use the dot marker to color your picture and then we get to play with bubbles. 5. Instruction: y Step 1: SLPA will model correct production of /p^/ and ask the child to imitate. SLPA will wear an exam glove and touch the child s lips as a tactile cue for /p/ and move away for the /^/ sound. SLPA will be careful to use her LEFT hand for her own lips and her RIGHT had for the child s lips. Any attempt to imitate the production will be verbally praised. SLPA will show the child using a mirror how the lips move to produce the sound. The SLPA will ask the child for 5 repetitions and record data using 3 marks: + means correct production, - means incorrect attempt and -0- means no attempt made. Step 2: SLPA will repeat Step 1 for CVCV as /p^p^/. Step 3: SLPA will repeat Step 1 for CVCVCV as /p^p^p^/. Step 4: SLPA will repeat Steps 1, 2, & 3 for /t^/ and for /k^/

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SLPA will introduce /p^t^k^/ and ask the child to imitate. Closure: Wow. touch the philtrum area above upper lip = /t/ and touch the top of the throat = /k/.nationalautismresources. Step 6: SLPA will blow bubbles and model saying Pop pop pop! as the child pops them. Step 7: SLPA will assign take home worksheet for parent to complete.y Step 5: If the child is successful. Also. the SLPA can ask the child to vary the pitch of the production to add a sing-song effect to the task. the SLPA can ask the child to blow the bubbles and use tactile cues (squishing the lips into fish lips ) to scaffold the child s attempts. 2|P a g e . The SLPA will verbally reinforce any attempts by the child to imitate the sounds. After each good production. 7. 9. Materials: y Mirror y Medical exam gloves y Do a dot picture sheet butterfly and fish to choose from y Do a dot art markers red or blue to choose from y The Pustefix Bubble Bear available at www.com y Take home practice worksheet see attached 10. Changing the Level of Complexity: To increase the complexity of the task. And look how pretty your picture is! Let s take it out and show mommy! Good job today see you tomorrow! 8. y y 6. Guided Practice: The SLPA will give tactile cues for each sound: touch both lips = /p/. Independent Practice: The parent will take home a practice worksheet to continue at home. listen to you talking! I m so proud of you. the SLPA will direct the child to add a colored dot to his picture as reinforcement for good productions.

Ø for no attempt.TAKE HOME SHEET FOR PEDIATRIC APRAXIA PRACTICE: Scoring = + for correct production. . 1 2 3 4 5 Total + Total - /p^/ /p^p^/ /p^p^p^/ /t^/ /t^t^/ /t^t^t^/ /k^/ /k^k^/ /k^k^k^/ Challenging: /p^t^k^/ 3|P a g e .for incorrect attempt.

It is important for story-telling that you are able to keep a good rhythm. Pre-practice/ Introduction: HI. Step 4: Halfway through the session. Objective: To improve prosodic features of speech to increase intelligibility.2 ADOLESCENT/ADULT . 2. Step 3: Student will continue to practice and repeat and SLPA will begin to diminish cues. 5. It s important to improve your speech patterns so you can do well on these projects. The SLPA will encourage the student to continue to practice and to think about rhythms of speech. And I KNOW you want to be able to tell your friends all about your weekend adventures. making an effort to notice rhythms around him. y y y y y 6. Today we are going to continue to work on the rhythm of our words so we can be understood better by our friends and teachers. Step 6: SLPA will assign take home worksheet. Step 5: SLPA will review with the client what he thinks went well and what he thinks needs extra practice. Instruction: y Step 1: SLPA will read the first poem aloud. The same procedures will be followed. 4|P a g e . Then the student and SLPA will read it together while they clap or tap the rhythm as they go.TREATMENT PLAN 3. Guided Practice: The SLPA will scaffold the student s rhythm/pace by signaling the downbeats of each line by tapping or waving a hand like an orchestra conductor. or if the client gets bored or frustrated with the selected poem. Motivation: Remember that in middle school and high school part of your grade is determined by your class participation and sometimes you even need to give a public presentation or oral report. Step 2: Student will recite the poem aloud while the SLPA provides cues to the rhythm by tapping or other motions. I ve selected some poems for us to work on and I think you will like them! 3. Purpose: You will see that when you master the art of rhythmic speech you will be understood more easily when you are talking. Our language and conversations have a very melodic quality to them. a different poem will be introduced. right? 4.Apraxia Target Population: Middle school student 1.

the SLPA can increase the pacing of the rhythm or select a poem with more tongue-twisting effects.7. Then at long last he knew What he wanted to do. Independent Practice: The student will take home a sheet with two limericks to practice aloud. the SLPA can change the poem style to a simpler form. As an extra challenge. Closure: Aren t those poems really funny? That kind of rhythm is called a limerick. They tend to have very silly themes we will read some more next time. He sent out a lot Of dit-dit-dash-dot But nobody knows what he said. but thought it a lot. Poems to Practice at Home: It Came from Outer Space There once was a Martian named Zed With antennae all over his head. To make the task more difficult. 8. Materials: y Poem book (I like The Hopeful Trout and Other Limericks by John Ciardi) y Take home practice worksheet see attached 10. But before he could start. couplet (two lines that rhyme). the student may choose to try to compose his own limerick to present to the SLPA next time. Changing the Level of Complexity: To make the task easier. The Thinker There was a young fellow who thought Very little. 5|P a g e . he forgot. 9.

thank you for working so hard today! Let s go tell Mom what a great day you 8. SLPA will provide verbal cuing and hand over hand assistance until student is able to do it on her own. Friend! y y 6. I want goldfish. Objective: To improve language skills by teaching 3 word sentence patterns using functional statements. today when you ask for goldfish crackers or bubbles. 7. Closure: had today! Wow. Materials: y Pacing Board with 3 circles y Goldfish crackers y Bubbles 6|P a g e . Eventually. the pacing board will be removed and the student will be asked to tap the table to keep pace. Then SLPA will say. and eventually the overt pacing behaviors will be faded completely. I have some fun activities planned for us today! 3. you will get that prize. Pre-practice/ Introduction: Good morning. Guided Practice: The SLPA will provide maximum verbal cuing and hand-over-hand assistance at first and then fade the supports over time until the student is able to imitate the motions independently.3 PEDIATRIC Dysarthria Target Population: Young elementary school child K-2 1. Step 3: SLPA will conclude the session by using the pacing board to say Good job today! and See you Thursday! or Good-bye. For each attempt. the SLPA will put one or two goldfish crackers in front of student as a reward. I m so happy to see you at speech today.TREATMENT PLAN 3. I want bubbles and More bubbles please . Now you try it: I want goldfish. Motivation: So. Instruction: y Step 1: SLPA will put pacing board in front of student and model touching each circle while saying each word. Purpose: I want to hear your best talking today because I want you to be able to ask for crackers and bubbles! 4. Do you understand? I know you like goldfish crackers and bubbles! 5. 2. Step 2: SLPA will alter the sentences modeled to include More goldfish please .

Independent Practice: The client will tell his wife that she is his best friend when she comes to visit. That s it! Great job! For sentences. Instruction: Step 1: SLPA will instruct client to take a deep breath and hold it while she counts to 5. 7|P a g e . Mr. You worked really hard today and you did a really great job. Step 2: SLPA will instruct client to take a deep breath and hold it while she counts to 3. For example: My WIFE is my best friend. My wife IS my best friend. My wife is my BEST friend. but varying the emphasis to alter the meaning of the sentence. The client will attempt this five times. Client may require hand-over-hand assistance at first to get the behavior started. 5. Objective: To improve respiratory control and improve prosody skills 2. I bet you can t wait to see her later today and tell her. 4. Pre-practice/ Introduction: Hello Mr. 1. Step 5: SLPA will instruct the client to repeat the sentences. The client will practice saying the sentences while touching a different circle for each syllable. Motivation: I know that when your beautiful bride of 42 years comes to visit you this afternoon. Jones. SLPA will fade supports as client increases performance. My wife is MY best friend.4 ADOLESCENT/ADULT . prolonging the /s/ sounds. 8. Guided Practice: The SLPA will model the breathing behaviors for the client. 6. Jones. She will provide verbal praise for attempts by saying Good try and positive feedback for success by saying.TREATMENT PLAN 3. Step 3: SLPA will instruct client to take a deep breath and release the air in a series of short and long patterns while repeating the word sassy . I will see you next time. you want to be able to tell her how much you love her ! So let s get busy so you can practice whispering sweet nothings in her ear later tonight. you are ready to tell your lovely wife that she is indeed your very best friend. Closure: Now. 7. Step 4: SLPA will give the client the pacing board with 6 circles and 10 sentences. Purpose: Today we are going to continue to work on breathing control and then we are going to practice some sentences and some different rhythm patterns. My wife is my best FRIEND. then slowly exhale while she counts to 3. You look great today! I m so glad to see you sitting up and ready for speech! 3.Dysarthria Target Population: Adult patient with dysarthria as a result of a cerebral stroke. SLPA will demonstrate pacing by tapping the board for each syllable.

and can introduce pitch variations into the sentence activity. Changing the Level of Complexity: To make the tasks easier.g. 8|P a g e . and can reduce the sentence length to 3 word phrases (e. Materials: Pacing Board with 10 6-syllable sentences. 10. the SLPA can increase the length of exhale time to a count of 7. the SLPA can require breath-holding for a count of 3 instead of 5. I will open the door becomes Open the door ) To increase the difficulty of the tasks.9.