Auditory Input / Naturalistic Intervention / Listening Techniques in Phonological Therapy
- Created on Monday, 14 November 2011 19:11
- Updated on Friday, 15 March 2013 19:09
Increasing Lexical Frequency
There are at least three potential ways of providing intensified, systematic, and repeated exposure to multiple exemplars of phonological structures and contrasts (Ingram, 1989). First, there are the techniques developed by Blache (1982), Weiner (1981) and others, often referred to as minimal contrast therapy or minimal pairs therapy; second, auditory bombardment (Hodson and Paden, 1983, Monahan, 1986); and third, auditory input therapy (Flynn & Lancaster, 1996) or naturalistic intervention (Camarata, 2010).
Increasing lexical frequency in input is considered to be a means of facilitating a child’s ability to recognise contrastive phones. It confronts them with the interconnections between the way a word is pronounced, the transmission of meaning, and communicative effectiveness. Auditory input activities, or "listening lists" are ways of increasing lexical frequency while controlling phonological input for limited periods, with the aim of presenting an opportunity for children to discover underlying phonological patterns for themselves.
Focused Auditory Stimulation
(Auditory Bombardment / AB)
Hodson and Paden (1983) developed the therapy procedure called auditory bombardment (AB) as a component of Cycles Therapy (Patterns Intervention). AB is a procedure in which the client is provided with intensified, repeated, systematic exposure to multiple exemplars of phonological targets and contrasts.
In the program described in Hodson & Paden, 1991 (pp 107-109) AB is but one important component. It should be emphasised that most of the time in each intervention session is devoted to games that specifically evoke production of the targets. The small auditory input component involves children listening to amplified target words at the beginning and end of every session.
Professor Hodson now prefers to use the term "focused auditory stimulation" (rather than "auditory bombardment") because of some concerns of caregivers and audiologists about possible negative connotations of the word "bombardment", in the sense that "bombardment" suggests the procedure is damaging to the ears (it is not!).
Hodson and Paden (1983) proposed that AB helped develop "auditory images", allowing the child to learn to monitor incorrect productions, while production practice produced kinaesthetic images, which also assisted in error monitoring.
Commenting on Hodson and Paden’s proposal, Ingram (1989) posited that a possible explanation for the apparent usefulness of auditory bombardment might lie in preliminary data from cross-linguistic studies of phonological acquisition.
Ingram cited the findings of Pye, Ingram and List (1987), which suggested that the acquisition of first sounds is influenced more by their linguistic prominence than by their assumed articulatory difficulty. For instance, monolingual French speaking children learn /v/ early, while it is acquired late by monolingual English speaking children. The incidence of /v/ in French is much higher than it is in English. Ingram (1989) suggested that auditory bombardment might facilitate phonological change by increasing the frequency of some targets.
Focused Auditory Input
Professor Hodson describes a second procedure called focused auditory input. It is intended for very young children who are unwilling or unable to produce targets when SLPs/SLTs first see them.
In this case NO production is demanded but the clinician designs the environment to provide for lots of opportunity for the child to hear the target sound or pattern.
The clinician essentially does language stimulation activities (following child's lead, talking about what the child is doing etc.) and in the process the child is exposed to many examples of the target. Focused auditory input may only be used for a single "cycle".
Auditory Input Therapy
Auditory input therapy (Lancaster & Pope, 1989; Flynn & Lancaster, 1996) has the advantage of being able to be implemented with very young children, with the active participation of caregivers. It incorporates minimal meaningful contrast therapy and metalinguistic activities. In essence, the approach involves setting up interesting and attractive games and tasks during which the child is exposed to multiple 'repetitions' of particular sound targets, spoken by the adult, with no requirement for them to practice saying words or sounds.
Camarata (2010) and co-workers use the term ‘Naturalistic Intervention’ to refer to similar ‘whole word’ procedures to improve the overall intelligibility of children with severe SSD, including children with Down syndrome, children with autism and children who stutter.
Multiple Exemplar Training in PACT
The Multiple Exemplar Training component of PACT comprises minimal pair activities and auditory bombardment with no amplification. There are many minimal contrast activities to choose from. Mostly they involve simple card games with minimal meaningful contrasts (MMC’s) pictured on playing cards, or on pictures pasted into children’s speech books ('homework books').
Sometimes maximal feature contrast are used in therapy, though it must be noted that in the research that validated PACT Therapy (Bowen, 1996) minimal contrasts were employed. Examples of training sets, always consisting of pictures, and usually accompanied by the written word are listed below.
Training sets of cards, or pictures in speech books, range in number from three pairs to nine pairs. All the activities are modelled for the children at first, until they understand what to do. For instance, the child might have to sort the cards into two piles, with vs. without final consonants when final consonant inclusion is being targeted (e.g., bow, go, sew in one pile, and boat, goat, soap, in the other).
Many of the minimal contrast activities can be modified (and often thereby improved and made more appealing to the children) by parents, older siblings, or by the children themselves, as they play the games. For example, many children tend to "personalise" an activity by including one of their toys as an integral part of it, or make an activity more elaborate or interesting in some other way.
- "Point to the one I say": in which the child points to pictures of the words, spoken in random order (e.g., glow, black, low, steam, back, team, glow), or rhyming order (e.g., low, glow, back, black, team, steam), by the therapist or parent.
- "Put the rhyming words with these words": in which the therapist or parent sets out three to nine cards (e.g., pat, peel, pill, pull) and the child places rhyming cards beside them (fat, feel, fill, full).
- "Say the word that rhymes with the one I say": in which the therapist or parent says words containing the target phoneme, and the child says the rhyming non-target word (e.g., the adult says, "fill" and the child says "pill").
- "Give me the word that rhymes with the one I say": in which the adult says the non-target word, and the child selects the rhyming word containing the target sound (e.g., the adult says, "pill" and the child selects "fill").
- "Tell me the one to give you": in which the child says the word, and the adult responds to the word actually said. So, for example, if the child attempted to say "fill", but produced it as "pill", the adult would give him or her "pill", causing them to experience a communication failure. This game is based on the homophony confrontation tasks described by Weiner (1981). The aim is for the children to realise the failure to communicate their message, and attempt to revise their production. In PACT Therapy (Bowen & Cupples, 1999) this is the only minimal contrast activity that is not included in homework. It requires a 'light' touch, and humour that the child finds funny and did not go on for too long. Games involving homophony confrontation are not played in therapy sessions when siblings are present, because of the possibility of their giving rise to teasing.
- "You be the teacher, and tell me if I say these words the right way or the wrong way": in which the adult says the words in rhyming or random order, and the child judges whether the words have been produced correctly or not.
- "Silly Sentences": in which the child judges whether a sentence is a "silly one" (e.g., the adult might say "We flew to Melbourne in a pane (plane)" and the child judges the sentence a "silly one").
- "Silly Dinners": is a variation of "Silly Sentences". The adult says what they want for dinner, and the child judges whether it is a "silly dinner" or not (e.g., "For my dinner I will have 20 hot ships (chips) and two delicious shops (chops)".
- "Shake-ups and Match-ups" a game in which the child is presented first with four picture cards representing minimal meaningful contrasts (MMC’s) such as: car/calf; tie/tight. The word-pairs are repeated to the child several times, and then the picture cards are put into a container and "shaken up". The child is then asked to take the cards out of the container, and arrange them on the table "the same as they were before" (i.e., in pairs).
- "Find the two-step words": in which the child sorts the words with consonant clusters SIWI from minimally contrasting words with singleton consonants SIWI (e.g., top/stop).
- "Walk when you hear the two-steps": in which the child "walks" with their fingers when they hear a consonant cluster syllable initial word initial (SIWI) as opposed to a singleton consonant SIWI.
In each activity the therapist or parent helps the child perform the task, gradually phasing out the help until the child is performing their part independently. The purpose of the tasks is explained (by the clinician) to the caregivers and the children themselves, as a good way of listening to, and "thinking about", the way words sound. Parents are instructed to encourage the children to "think the words in your mind" while performing sorting tasks.
Including graphemes (printed words) means that sometimes the children sort pictures visually as well as, or possibly instead of, auditorily. If they do, it is encouraged, and viewed as an additional way for children to find systematic patterns and correspondence between linguistic levels.
Minimal contrast activities typically provide a natural lead-in to a brief "input" of auditory bombardment, and the boundaries between where minimal contrast activities finish, and auditory bombardment activities take over, are sometimes blurred. Minimal contrast training sets sometimes double as listening list words.
Auditory Bombardment in PACT
In PACT Therapy (Bowen, 1996, 1998, 2009b, 2010a) auditory bombardment is a component of Multiple Exemplar Training. It involves the child in:
- listening to words with common phonetic features (e.g., all starting with a particular target sound), or
- listening to minimally contrasted words exemplifying a phonological process (e.g., tea-key, tap-cap, etc for velar fronting; or moo-moon, buy-bite, etc for final consonant deletion; or top-stop, nail-snail, etc for cluster reduction),
- hearing alliterative input in the context of games and stories
- Auditory Input Therapy (Thematic Play / Naturalistic Intervention).
Auditory bombardment is used in PACT on the basis that phonological progress is sensitive to phonological input (Ingram, 1989). In practice there is overlap between the auditory bombardment activities and the minimal pair games (above).
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Bowen, C. (1998). Developmental phonological disorders: A practical guide for families and teachers. Melbourne: The Australian Council for Educational Research Ltd.
Bowen, C. (2009b). Working with PACT. In C. Bowen, Children's speech sound disorders. Oxford: Wiley-Blackwell, pp. 296-340.
Bowen, C. (2010a). Parents and children together (PACT) intervention for children with speech sound disorders. In Williams, A.L., McLeod S. & McCauley. (Eds.).Interventions for Speech Sound Disorders in Children. Paul Brookes.
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Pye, C., Ingram, D., & List, H. (1987). A comparison of initial consonant acquisition in English and Quiche. In K.E. Nelson & A. Van Kleek (Eds.). Children’s Language. Hillsdale, NJ: Erlbaum.
Weiner, F. (1981). Treatment of phonological disability using the method of meaningful contrast: Two case studies. Journal of Speech and Hearing Disorders, 46, 97-103.