Clinics in communication disorders最新文献

This article provides some suggestions for clinicians to assist them in working effectively with students and families who do not speak English or for whom English is a second language. Included is a brief review of the diversity of languages and cultures represented by families living in the United States. There are differences in the ways in which the families view language development, the educational process, and their roles in working with their children. It is important to learn to respect the families' views on language development and education, learn how to work with an interpreter, and how to help the families help their children. Communication with the families and their involvement in the process of assisting their children's development of language skills should be individualized to accommodate the families' views, languages, and available resources.

Hawaii's system of prevention and early intervention embodies Part H principles that a child with a disability is first surrounded by a family, then by a community. Since 1986, families in Hawaii have been active in early intervention, first by persuading the governor to name the Department of Health as the lead agency, and then by writing much of the original grant application, interviewing and selecting staff members, and serving on the Hawaii Early Intervention Coordinating Council and its subcommittees. Families helped develop Hawaii's broad definition of the population to be served and were vocal advocates before the legislature to obtain funding for the program. Under Part H, Hawaii serves 6% of all children under the age of three, a larger percentage than any other state. Services focus on the family's needs as much as on the child's. The Individualized Family Support Plan (IFSP), developed jointly by the parents and professionals, recognizes families as the final decision-maker on the IFSP team. Families choose options that fit their needs. IFSP meetings are at times and places convenient to families and, to the extent feasible, in the family's native language. Care coordinators, of whom several are parents of children with special needs, monitor services to ensure that families receive quality care. Families receive (1) services at no cost, (2) preference when applying for positions in the Zero-to-Three Hawaii Project, and (3) compensation when serving in advisory or policy-making areas. In Hawaii, families are the center of early intervention services.

In this article a case study is used to demonstrate the contributions of parents to the diagnostic and intervention process in home-based therapy. Two assumptions of Vygotskian theory form the bases for this conceptualization: (1) that individual mental functioning has social origins, and (2) that individuals appropriate their ways of talking and thinking from the sociocultural routines and practices in which they are embedded. Given these assumptions, the role of the parent is presented as essential to assessment and treatment because the talk of the child is jointly constructed with them and within home activities. The case study functions as an example of how parents are instrumental to our therapeutic work.

This article discusses the strategies for building partnerships with parents and for achieving collaboration among parents, teachers, and speech-language pathologists, all of whom are agents who will influence the process of the child's speech-language learning process. The changes in educational philosophy and related laws, and in the role of parents, are discussed. Common concerns of parents of children with communication disorders are discussed.

Three mothers of children with severe communication disabilities describe their experiences with speech-language pathologists and the intervention process. The parents were asked open-ended and descriptive questions. Their responses provide valuable insights and direction for professionals interested in working more closely with families of children with disabilities. The mothers describe their role as primary case managers for their children's treatment programs. They identify the type of speech-language pathologist they prefer to work with their child and the professional guidance they find most helpful. Several recommendations for communication disorders professionals evolved from the discussion.

This article focuses on the preparation of undergraduate and graduate students in Human Communication Sciences and Disorders, for provision of services that involve families. The author discusses the identification of a family-oriented clinical model, the identification of the prerequisites needed for students' entry into clinical training in the family-oriented model, the prerequisites that students need to develop for independent clinical practice, and the management of common challenges faced by students as they participate in the family-oriented model. Evaluation forms are provided to assist the supervisor in the preparation of student clinicians.

The purpose of this article has been to present a theoretical construct that would enhance our understanding of the basis of the disorder apraxia of speech, whether it be developmental or acquired. From a theoretical explanation a conceptual framework was developed to guide the selection of appropriate treatment strategies. DAS, like acquired apraxia of speech, is conceived here as a sensorimotor impairment. The sensorimotor impairment is based on reduced or aberrant reafference. Thus, tactile or kinesthetic methods of treatment, as well as treatment techniques that may facilitate the processing of peripheral sensation (such as slowed speech), have been proposed as being the most facilitative. The hypotheses proposed herein require extensive investigation. Nonetheless, according to a number of clinical reports, methods that highlight movement sequences and methods that heighten the melodic line and slow rate are the ones that have gained the greatest favor in the treatment of children with DAS and adults with acquired apraxia of speech.

The therapeutic process is a mix of technique and insight, and effective clinicians are able to blend theory with practice. This is especially true in the area of DAS. Children with the symptom complex of apraxia are a challenge to any therapy program. Clinicians should choose combinations of therapy protocols that best serve the child. MIT is one technique that has been shown to be successful.

The Motor Speech Treatment Hierarchy used to guide PROMPT intervention represents a theoretical framework for the application of all bottom-up motor speech treatments. In addition, the hierarchy can be used prior to motor speech treatment to evaluate what aspects of the child's neuromotor system are intact and which elements are operating ineffectively or partially. When consideration is given to the development of the speech motor system and the interaction among the various valves and/or articulators, it becomes apparent that treatment must focus on the integration of all these aspects in order to be successful. The goal of intervention must be the voluntary control of all speech actions. But voluntary control of all speech actions is not possible for all children, and the clinician must realize that compensatory actions, although beneficial in the short term, will limit more complex interactions later. It is for these reasons that more attention should be given to mastery of control at the lower stages of the hierarchy. The clinician should not assume that all actions are intact based upon the perceived quality of speech. For the child with "pure" DAS, intervention usually begins at stage V or VI, whereas for children with developmental dysarthria, intervention begins at lower levels of the hierarchy. The responsibility, as always, lies with the clinician to determine the most appropriate level at which intervention should begin and the steps needed to achieve the best speech production. The clinician's knowledge provides the foundation for changing deviant motor speech patterns and for providing for our clients voluntary control of motor speech function. It has been the aim of this article to provide for clinicians a framework for treatment that will enhance their clinical effectiveness.