To improve productions of selected consonants and vowels

To improve listening skills for articulation targets

To improve prosodic features

To improve overall intelligibility for conversational contexts

Improve productions of back-velars, fricatives, and affricates in words, sentence and conversations

Reduce voiced/voiceless errors on stops and fricatives

Improve productions of frontal vowels and diphthongs

Reinforce listening skills for articulation targets

Reinforce co-articulation skills at the syllable and word- to-word level

Enhance conversational intelligibility

Same goals as 1st quarter with an additional goal of improving suprasegmental and temporal features including pausing, blending and rate in structured contexts

To continue to improve and maintain voiced/voiceless distinctions and the productions of fricatives, affricates and blends

Reinforce improved productions of diphthongs and frontal vowels

Reinforce listening for correct productions of target sounds

Reinforce suprasegmental and temporal features in connected speech

Increase conversational intelligibility for specific contexts designated by the student

Student 3 has just completed his third quarter of instruction and accumulated 43 hours of instruction. The results of instruction are summarized below.

Articulation: Improvements have been achieved and are evident in both formal tests and instructor and student observations. At the end of the 3rd quarter of instruction, test results are compared with the intake assessment scores. Fisher-Logemann Test of Articulation Competence (words), results were as follows: 31% consonant error (26% improvement); 12.5% vowel error (54%improvemnet); 28% total error (29% improvement). Compared to the error patterns on the intake exam, Student 4 has made significant changes across all the phoneme categories including sounds that were not targeted. There was only one omission, 40% fewer voiced/voiceless errors and generally minor distortions that do not significantly impact on intelligibility.

Changes were also revealed on the NTID Write-Down Test:

Intake score: 72% (3.4)
1st quarter post: 76% (3.6)
2nd quarter post: 78% (3.6)
3rd quarter post: 82% (3.8)
(10% gain since instruction began)

Throughout instruction, this student displayed good stimulability skills and developed an excellent understanding of the distinctive features of his target sounds. This knowledge facilitated the changes he was able to achieve. The Real-Time Spectrogram program on the Kay Computerized Speech Lab was frequently utilized to enhance instruction as it provided important visual feedback.Therapy materials were generated from various sources, including some designed by the instructor and the student, and some generated from news magazines and commercial workbooks. Phonemes were practiced in phrases and sentences and in conversational contexts.

Listening training was employed during all sessions, and attempts were made to work on the same targets that were focused on in aural rehabilitation. In structured contexts, the student made significant progress and achieved closer approximations particularly with the fricatives, affricates and vowels. He was also able to achieve voiced/ voiceless distinctions for stop sounds. The back-velar sounds, however, proved to be more challenging even in the drill exercises. Less success was achieved on the stops, affricates and several vowels and diphthongs when practice shifted to a less controlled context.

Therapy conversations often generated words that were important to the student’s everyday communication needs and interests. Select words and phrases were practiced and improvements in intelligibility were observed. The student also reported more success in being understood outside the therapy sessions.

Features such as linking words, employing appropriate syllable and word stress and pausing were practiced. Listening training was also employed to reinforce appropriate temporal patterns. Improvements were evident in structured practice and in several oral readings.
Listen to audio sample

More work in this area is needed to reinforce carryover to spontaneous speech.

At the end of instruction, Student 3 participated in a videotaped interview conducted by this instructor. During the interview the student reflected on his own progress and the gains in intelligibility that he was able to achieve. The student’s comments revealed very positive perceptions of the benefits of therapy including being understood more by people outside of RIT and having a better understanding of his speaking skills. He attributed his satisfaction to a variety of factors, including his involvement in the therapy process and goal establishment. He also felt that taking therapy concurrently with aural rehabilitation was very helpful. This interview also served as an additional efficacy measurement for the instruction provided.

View the 3-part interview:

Part I

Part II

Part III

Discharge Status:

Student 3 was discharged since he was graduating. He could still benefit from further intervention to monitor and reinforce the changes he has achieved and to work on additional improvements in his articulation and prosody that still might be achieved. His motivation remains very strong, and he plans on continuing therapy wherever he resides in the future.

Case Study #1

Case Study #2

Case Study #4