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Æathy Æendrick

SLPA 216/218 Fieldwork Practicum


Treatment Plan 3
2-22-2011

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Target Population: Pre-school: Age 3

1.‘ u : 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.‘  : ͞Good morning! I͛m 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?͟

î ‘ : ͞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. Let͛s get started.͟‘
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4.‘  ͞While we practice you can use the dot marker to color your picture and then we
get to play with bubbles.͟

5.‘ :

‘ ¬ c SLPA will model correct production of /p^/ and ask the child to imitate. SLPA
will wear an exam glove and touch the child͛s 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 child͛s 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.

‘ ¬  SLPA will repeat Step 1 for CVCV as /p^p^/.

‘ ¬
 SLPA will repeat Step 1 for CVCVCV as /p^p^p^/.

‘ ¬  SLPA will repeat Steps 1, 2, & 3 for /t^/ and for /k^/

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‘ ¬  If the child is successful, SLPA will introduce /p^t^k^/ and ask the child to
imitate.

‘ ¬  SLPA will blow bubbles and model saying ͞Pop pop pop!͟ as the child pops
them. The SLPA will verbally reinforce any attempts by the child to imitate the sounds.

‘ ¬ ! SLPA will assign take home worksheet for parent to complete.

 ‘ [ : The SLPA will give tactile cues for each sound: touch both lips = /p/, touch the
philtrum area above upper lip = /t/ and touch the top of the throat = /k/. After each good
production, the SLPA will direct the child to add a colored dot to his picture as reinforcement for
good productions. ‘
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7.‘  ͞Wow, listen to you talking! I͛m so proud of you. And look how pretty your picture is!
Let͛s take it out and show mommy! Good job today ʹ see you tomorrow!͟

8.‘  : The parent will take home a practice worksheet to continue at home.

9.‘ 
‘ airror
‘ aedical exam gloves
‘ Do a dot picture sheet ʹ butterfly and fish to choose from
‘ Do a dot art markers ʹ red or blue to choose from
‘ The Pustefix Bubble Bear ʹ available at www.nationalautismresources.com
‘ Take home practice worksheet ʹ see attached

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To increase the complexity of the task, the SLPA can ask the child to vary the pitch of the
production to add a sing-song effect to the task. Also, the SLPA can ask the child to blow the
bubbles and use tactile cues (squishing the lips into ͞fish lips͟) to scaffold the child͛s attempts.

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$ %u ¬% &u   ' 
Scoring ( ) #  *  #  * + #  
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   )  

/p^/
/p^p^/
/p^p^p^/
/t^/
/t^t^/
/t^t^t^/
/k^/
/k^k^/
/k^k^k^/

Challenging:

/p^t^k^/

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Target Population: aiddle school student

1.‘ u : To improve prosodic features of speech to increase intelligibility.

2.‘  : ͞HI. 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. I͛ve selected some poems
for us to work on and I think you will like them!͟

î ‘ : ͞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. It is important for story-telling that you are able to keep a good
rhythm. And I Æ OW you want to be able to tell your friends all about your weekend
adventures, right? ͟‘
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4.‘  ͞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. It͛s important to improve your speech patterns so you can do well on these projects.͟

5.‘ :

‘ ¬ c SLPA will read the first poem aloud. Then the student and SLPA will read it
together while they clap or tap the rhythm as they go.

‘ ¬  Student will recite the poem aloud while the SLPA provides cues to the rhythm
by tapping or other motions.

‘ ¬
 Student will continue to practice and repeat and SLPA will begin to diminish
cues.

‘ ¬  Halfway through the session, or if the client gets bored or frustrated with the
selected poem, a different poem will be introduced. The same procedures will be
followed.

‘ ¬  SLPA will review with the client what he thinks went well and what he thinks
needs extra practice. The SLPA will encourage the student to continue to practice and
to think about rhythms of speech, making an effort to notice rhythms around him.

‘ ¬  SLPA will assign take home worksheet.

 ‘ [ : The SLPA will scaffold the student͛s rhythm/pace by signaling the downbeats
of each line by tapping or waving a hand like an orchestra conductor.‘
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7.‘  ͞Aren͛t those poems really funny? That kind of rhythm is called a limerick. They tend
to have very silly themes ʹ we will read some more next time.͟

8.‘  : The student will take home a sheet with two limericks to practice aloud.
As an extra challenge, the student may choose to try to compose his own limerick to present to
the SLPA next time.

9.‘ 
‘ Poem book (I like × × 
 
   by John Ciardi)
‘ Take home practice worksheet ʹ see attached

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To make the task easier, the SLPA can change the poem style to a simpler form, couplet (two
lines that rhyme). To make the task more difficult, the SLPA can increase the pacing of the
rhythm or select a poem with more tongue-twisting effects.

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There once was a aartian named Zed There was a young fellow who thought
With antennae all over his head. Very little, but thought it a lot.
He sent out a lot Then at long last he knew
Of dit-dit-dash-dot What he wanted to do,
But nobody knows what he said. But before he could start, he forgot.

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Target Population: Young elementary school child ʹ Æ-2
c ‘ u : To improve language skills by teaching 3 word sentence patterns using functional
statements.

 ‘  : ͞Good morning. I͛m so happy to see you at speech today. I have
some fun activities planned for us today!͟

î ‘ : ͞I want to hear your best talking today because I want you to be able to ask for
crackers and bubbles!͟‘
‘
 ‘  ͞So, today when you ask for goldfish crackers or bubbles, you will get that prize.
Do you understand? I know you like goldfish crackers and bubbles!͟

 ‘ :

‘ ¬ c SLPA will put pacing board in front of student and model touching each circle while
saying each word, ͞I want goldfish.͟ Then SLPA will say, ͞ ow you try it: I want goldfish.͟ SLPA
will provide verbal cuing and hand over hand assistance until student is able to do it on her own.
For each attempt, the SLPA will put one or two goldfish crackers in front of student as a reward.

‘ ¬  SLPA will alter the sentences modeled to include ͞aore goldfish please͟, ͞I want
bubbles͟ and ͞aore bubbles please͟.

‘ ¬
 SLPA will conclude the session by using the pacing board to say ͞Good job today!͟ and
͞See you Thursday!͟ or ͞Good-bye, Friend!͟

[ : 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. Eventually, the pacing board will be removed and the student will be asked to tap
the table to keep pace, and eventually the overt pacing behaviors will be faded completely.
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!  ͞Wow, thank you for working so hard today! Let͛s go tell aom what a great day you
had today!͟

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‘ Pacing Board with 3 circles
‘ Goldfish crackers
‘ Bubbles

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Target Population: Adult patient with dysarthria as a result of a cerebral stroke.

c ‘ u : To improve respiratory control and improve prosody skills

 ‘  : ͞Hello ar. Jones. You look great today! I͛m so glad to see you
sitting up and ready for speech!͟

î ‘ : ͞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.͟‘
‘
 ‘  ͞I know that when your beautiful bride of 42 years comes to visit you this
afternoon, you want to be able to tell her how much you love her͙! So let͛s get busy so you can
practice whispering sweet nothings in her ear later tonight.͟

 ‘ :

¬ c SLPA will instruct client to take a deep breath and hold it while she counts to 5. The
client will attempt this five times.

¬  SLPA will instruct client to take a deep breath and hold it while she counts to 3, then
slowly exhale while she counts to 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 ͞sassy͟, prolonging the /s/ sounds.

¬  SLPA will give the client the pacing board with 6 circles and 10 sentences. The client
will practice saying the sentences while touching a different circle for each syllable.

¬  SLPA will instruct the client to repeat the sentences, but varying the emphasis to
alter the meaning of the sentence. For example: ay WIFE is my best friend; ay wife IS my
best friend; ay wife is aY best friend; ay wife is my BEST friend. ay wife is my best
FRIE D.

 ‘ [ : The SLPA will model the breathing behaviors for the client. She will provide
verbal praise for attempts by saying ͞Good try͟ and positive feedback for success by saying,
͞That͛s it! Great job!͟ For sentences, SLPA will demonstrate pacing by tapping the board for
each syllable. Client may require hand-over-hand assistance at first to get the behavior started.
SLPA will fade supports as client increases performance. ‘
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! ‘  ͞ ow, ar. Jones, you are ready to tell your lovely wife that she is indeed your very
best friend. I bet you can͛t wait to see her later today and tell her. I will see you next time. You
worked really hard today and you did a really great job.͟

6 ‘  : The client will tell his wife that she is his best friend when she comes to
visit.

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Pacing Board with 10 6-syllable sentences.

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To make the tasks easier, the SLPA can require breath-holding for a count of 3 instead of 5, and
can reduce the sentence length to 3 word phrases (e.g.͟ I will open the door͟ becomes ͞Open
the door͟)
To increase the difficulty of the tasks, the SLPA can increase the length of exhale time to a count
of 7, and can introduce pitch variations into the sentence activity.

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