Compelling Case Studies & Research: PROMPT in Action · 2019-02-08 · this presentation: PROMPT...
Transcript of Compelling Case Studies & Research: PROMPT in Action · 2019-02-08 · this presentation: PROMPT...
Compelling Case Studies & Research: PROMPT in Action
GSHA 2019 -- February 15, 2019
Disclosure Statement I have the following relevant relationship in the services described and reviewed in this presentation:
PROMPT Institute• Contract employee which entails
conducting PROMPT courses and PROMPT Instructor responsibilities.
After GSHA 1977
Learning Objectives• Identify Movement patterns as they apply
to the System Analysis Observation (SAO) and Motor Speech Hierarchy (MSH)
• Identify Priorities as they apply to the Motor Speech Hierarchy (MSH) and Conceptual Framework (CF)
• List and explain Key Features of PROMPT Treatment
What is the PROMPT Institute?
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PROMPT INSTITUTE
SANTA FE, NEW MEXICO www.prompt.org
• A Non-Profit Organization dedicated to improving verbal communication and interactions for children and adults.
• Research• Treatment grants• 50 instructors worldwide • Trained 40,000 SLP worldwide• PROMPT in different languages
Who can offer PROMPT treatment?
• Only speech-language pathologists are trained by the PROMPT Institute
• Four levels of PROMPT education§ PROMPT Trained
o PROMPT: Introduction to Techniqueo Bridging PROMPT to Intervention
§ PROMPT Certified Clinician§ PROMPT Certified Instructor
Sample of PROMPT Therapy
What makes “PROMPT” PROMPT?
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TKP input Motor Speech
Assessment
Conceptual Framework
Treatment Activities
What is the PROMPT Technique?
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TKP input
WHAT IS PROMPT?
• Prompts for• Restructuring• Oral• Muscular• Phonetic• Targets
– A tactile-kinesthetic-proprioceptive (touch-movement) based treatment method
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Surface Parameter Syllable
Complex
Levels of PROMPTing
Physiological (muscular)
Neurological (motor)
Refined, stable motor speech control
What is the Tactile-Kinesthetic-Proprioceptive input doing to the brain?
What is the Tactile-Kinesthetic-Proprioceptive input doing to the brain?
Clinician acts as external programmer by giving TKP input…
to develop/restructure connections…
which then changes the output!
PROMPT the entire word • to form holistic construct for the motor plan • highlight transitions from and to target
phonemes
Current PROMPT Research
Cite: Namasivayam, A. K., Granata, F., Huynh, A., & Van Lieshout, P.H.H.M. (2018). Randomized Control Trial of PROMPT Intervention for Children With Severe Speech Sound Disorders. Presentation at the American Speech-Language-Hearing Association Convention, Boston, USA (November 15–17).
What is the PROMPT Approach?
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TKP input Motor Speech
Assessment
MotorSpeechHierarchySpeechSubsystems
SystemsAnalysisObservation
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TONE
Increased/decreased tone Neurological concerns Postural support
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PHONATORY CONTROL
Airflow Breath support Phonation/valving
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MANDIBULAR CONTROL
Jaw stability Jaw grading Up/down movements
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LABIAL-FACIALCONTROL
Medial 1/3 Lip contact Lip-jaw dissociation Independent lower lip Retracting Rounding
SampleVideo
• RyanandLilly
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LINGUAL CONTROL
Anterior Mid Mid-back Posterior
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SampleVideo
• Will
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SEQUENCED MOVEMENTS
Vocal timing Smooth, coordinated transitions Optimal functioning of all speech subsystems
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PROSODY
Integration of breath support, phrasing, stress, rate, loudness
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• Systems are inter-connected
• Analyze the
system, find the point of breakdown(s)
• Examine as a
whole system!
• Select 3 subsystems for treatment
LookatMovementNOTspecificsounds
• Phonemesaremultidimensional-• Phonation• Jaw• Lips• Tongue
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ClinicalImplication
• ConsonantandVowelCombinations• Needtothinkbeyondthesyllableshape.
• CVo Moo,Ma,Me
• VCo On,Eat
• CVCo Bop,Beep
• CVCVo Dada,Mommy,Puppy,Bye-bye
• VCVo Anna,oboe,Ido
TrajectoryofWords
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• Vowels• Shiftawayfromtraditionalarticulationfromconsonants
Lookatthissystem!
• Lana,4years,10months• Whatsoundsdidyouhear?• Nowlet’stakealookatmotor!
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AdditionalPROMPTAssessmentComponents
GlobalDomainAnalysis• Physical-Sensory• Cognitive-Linguistic• Social-Emotional
KnowledgeofexternalenvironmentDeterminesupportstrategies
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Physical Sensory DomainAreas to observe General Assessment
Questions
Skeletal Structure How does the client’s skeletal structure and muscular development impact movement?
Sensation What is the status of the neuromuscular system?How well do the sensory organs function?
Neuromuscular Integrity What factors impact global motor and speech motor control?
Cognitive Linguistic DomainAreas to observe General Assessment
QuestionsPerception; sensation, discrimination, recognition
How does the client process information and interact with the environment to learn?
Concept Formation How does the environment need to be structured for learning?
What modifications are necessary for the client to learn?
Social Emotional DomainAreas to observe General Assessment
Questions
Interpersonal Interactions How does the client express their needs and wants?
Trust What communicative functions does the client exhibit?
How does the client use significant others to aid in the acquisition of knowledge
What is the PROMPT Philosophy?
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TKP input Motor Speech
Assessment
Conceptual Framework
The PROMPT Philosophy
HolisticPROMPT
Conceptual Framework
PROMPT Tenets
EnvironmentExternal
PROMPTConceptualFramework
Client
Internal
Hayden02
CulturalPhysicalSocial
intrapersonal
interpersonal
PhysicalSensorySkeletalStructureNeuromuscularIntegritySensation
CognitiveLinguisticPerceptionsensationdiscriminationrecognitionConceptFormation
SocialEmotionalInterpersonalInteractionTrust
Sensory-Motor
Communication
BehavioralOutcomes
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EnvironmentExternal
PROMPT Conceptual Framework
Client
Internal
Hayden02
CulturalPhysicalSocial
intrapersonal
interpersonal
PhysicalSensorySkeletalStructureNeuromuscularIntegritySensation
CognitiveLinguisticPerceptionsensationdiscriminationrecognitionConceptFormation
SocialEmotionalInterpersonalInteractionTrust
Sensory-Motor
Communication
BehavioralOutcomes
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PROMPTisusedwithChildrenandAdults
PublishedPapers
SpeechSoundDisorders ü
DevelopmentalDelays
MotorSpeechDisorders• Dysarthria• ApraxiaofSpeech
üü
HearingImpairment
AutismSpectrumDisorders üFluencyDisorders
ForeignAccentModification
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What is the PROMPT System?
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TKP input Motor Speech
Assessment
Conceptual Framework
Treatment Activities
PROMPT as a Systemfor organizing and executing a treatment plan
Use data from Domains
Evaluation
Use SAO & MSH to select Motor
Speech Priorities
Develop Goals & Objectives,
Motor-Phoneme Targets, Lexicon,
Activities
Sessions
• Motor goals• Select target motor-
phoneme links• Create meaningful and
functional lexicon • Embed lexicon into
functional, interactive routines/activities
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Treatment videos
Considerations: Traditional Therapy and PROMPT
What makes “PROMPT” PROMPT?
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TKP input Motor Speech
Assessment
Conceptual Framework
Treatment Activities
Online Courses/ Mentoring
Technique Practicum
PROMPT Pathway to Certification
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Introduction to
Technique
Certification Project
Bridging – Technique
to Intervention
OnlineCourses/Mentoring
TechniquePracticum
PROMPTPathwaytoCertification
X
IntroductiontoTechnique
CertificationProject
Bridging–TechniquetoIntervention
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Questions?
THANK YOU!
You are welcome to contact meGayle Merrefield
For additional information please visit
www.prompt.org