GROUP

Language therapy

language therapy &

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THERAPY

The   purpose   of   the   therapy  groups   is   to   use   real   social  

situations   to   enhance   the  

production  of  speech  and  language  

In the

In   the   early   1950´s,   two  pioneers  in   the   field   of   speech-­‐language  pathology,   Ollie   Backus   and   Jane  Beasley,   developed   guidelines   for  the  introduction  of  groups  into  the  therapy  process  

Natural Interpersonal INTERACTIONS

BUT

Beyond   these  efforts,   little   has  been   done   to  develop   the  understanding,  benefits,   and   use  of  group  dynamics  in   speech-­‐language  therapy        

Cooperative Learning?

According  to  Johnson  and  Johnson  (1982),  a  cooperative   learning   group   consist   of”  two   or   more   individuals   in   face.to-­‐face  interaction,   each   aware   of   his   or   her  membership   in   the   group,   and   each   aware  of   their   positive   interdependences   they  strive   to  achieve  mutual  goals”  

Main Objectives

Positive   Interdependence:   the   group   members   must   work  together  to  accomplish  shared  goals  

Face–to-­‐face   Interaction:   the   group   members   must   establish  interactional  patterns  that  promote  a  positive  learning  environment  

Individual   Accountability:   Each   group  member   is   responsible   for  achieving   his   or   her   own   goals   and   for   assisting   other   group  members  to  achieve  theirs.  

Interactional   and   Group   Skills:   the   group   members   must   be  taught  the  necessary  social  skills  for  effective  group  collaboration    

For Speech- Language Therapy Groups is

necessary to

consider….

PHASES PLANNING  

IMPLEMENTING  

EVALUATING  

PLANNING  During  this  phase  the  clinician  makes  critical  decisions  about  the  structure   and   content   of   the   cooperative   speech-­‐language   therapy  group    

Are  Specification  Objectives:  

Is   necessary   to   specify   two   types  of  objectives  for  every  cooperative  speech-­‐language  therapy  group:  

∗ Speech/language  objectives:    Refer   to   particular   speech  and/or   language   targets   that  are   specific   to   each   group  member  

∗ Cooperative  objectives:  Involve   learning   the   rules   of  language  use  in  social  contexts  

Determination  of  Group  Size:  

The   size  of   group   therapy  varies  according   to   the   social   maturity  of   the   group   members,   the  materials   and   the   activities,   and  the  time  available  for  the  therapy  session    

Establishment   of   Group  Composition  

The   group   therapy   should   be  composed   of   members   with  various   kinds   and   degrees   of  speech  and/or  language  disorders.  One   advantage   is   that   each  member  can  do  something  well.    

Arrangement  of  group  members    

The  group  members  should  sit  in  a  circle  to  provide  opportunities  for  effective  face-­‐to-­‐face  interaction    

Structuring  Materials    

Material   selection,   distribution  and   use   are   important  considerations;   in   the   initial  stages,   we   suggest   using   familiar  materials,   in   the   later   stages   the  material   can   be   more   complex.  

Specifying  Cooperative  Skills  

In   cooperative   skills,   including  communication,   building   and  maintaining   trust,   providing  leadership,   and   managing  conflicts,   effective   communication  is  by  far  the  most  important  to  the  successful   operation   of   speech-­‐

IMPLEMENTING  

EVALUATING  

During  this  phase  the  clinician  introduces  the   lesson  and  carries  out  the  procedures  specified  during  Planning.    

Monitoring  Students´  Behavior  

The  clinician  needs  to  observe  the  group   members   in   order   to  identify  problems  in  produce  their  speech  and   language   targets  or   in  

Intervening   to   Teach   Speech,  Language,   and   Cooperative  skills.  

The   clinician   assumes   a  consultative   role,   intervening   to  teach   specific   skills   only   if   the  student  are  having  difficulty  

Closing  the  Lesson    

At  the  end  of  the  session,  the  students  should  summarize  what  they  have  learned   about   using   their   speech   and   language   targets   in   real  interpersonal  exchanges.  

The  final  evaluating  phase  occurs  after  the  lesson  has  been  completed  and  summarized  

Evaluating   Use   of   Speech,  Language   and   Cooperative  Skills    

The  clinician  evaluates  each  group  member´s   performance   on   their  individual   speech   and   language  targets,  the  clinician  also  note  how  effectively  the  group  collaborated    

Discussing  Group  Interactions    

The   group   members   have   two  primary  responsibilities:  

∗ To  accomplish  their  speech  and  language  goals  

∗ To  build  and  maintain  effective  working   relationship  with   each  other.  

Open   discussion   of   how   well   the  group   functioned,   at   the   end   of  each  session.  

language therapy

Intensity   of   therapy   is   a  strong   predictor   of   outcome  in  speech  treatment.  Research  has   shown   that   intensive  speech  therapy  has   functional  and  neural  effects

→ Intensive   speech   therapy  results   in   immediate   changes  in   the   posterior   part   of   the  superior  temporal  gyrus  in  the  right  hemisphere,  homologous  to  Wernicke’s  area  (Musson  et  al.,  1999).  

FUNCTIONAL  EFFECTS  

→ Intensive   speech   therapy  results   in   significant  improvements,  which  cannot  be  explained   by   spontaneous  recovery   (Poeck,   Huber,   &  Willmes,  1989).  → Aphasia   treatment   studies  with  positive  outcome  tended  to  provide  more   intensive   therapy  than   those   with   negative  outcome   (Bhogal,   Teasell   &  Speechley,  2003).

NEURAL  EFFECTS  

→ Comparison  of  brain  imaging  study   before   and   after  intensive  speech   therapy   for  4-­‐6   weeks   shows   an  increased   activity   in   the  peri-­‐lesional   area   (Leger   et  al.,   2002;   Davis,   Harrington,  &  Baynes,  2006).

→ Intensive   therapy   has   better  outcome  than  regular  therapy  (Basso  &  Caporali,  2001).    

→ Significant   improvements  were   observed   during   the  intensive   treatment   phase  only   (Brindley,   Copeland,  Demain,   &   Martyn,   1989;  Mackenzie,   1991;   Hinckley   &  Craig,  1998).  

Although   research   indicates   that  intensive   speech   therapy   is   more  effective   than   non-­‐intensive   therapy,   the  amount   and   frequency   of   treatment   is  routinely   determined   depending   on   the  availability   of   speech-­‐language  pathologists  at  clinical  settings.    

Furthermore,   it   is   largely  unknown  what  individual   patients   and   their   caregivers  would   consider   an   adequate   amount   of  speech  therapy.  

The   intensive   regimen   delivered   over   an  extended   period   of   time   results   in  significant   improvement   in  communication  skills  

Adults   with   aphasia   show   significant  improvement   in   their   language   skills   after  receiving   at   least   9   hours   of   therapy   or  more  per  week.  

This   improvement   can   be   seen   regardless  of  severity  or  type  of  aphasia  at  any  stage  of  recovery.   Adults   with   global   aphasia  respond   positively   to   an   intensive   therapy  

REFERENCES

∗ Ingram, K., Choe, Y., Mathy, P. and Azuma, T. Clients´ utilization and satisfaction with intensive therapy in aphasia. Arizona Stage University.

∗ Lieberman, R., Michael, A. (1986). Group therapy revisited: using cooperative learning procedures in speech- language therapy. National Student Speech Language Hearing Association Journal, pp. 51-67.

∗ Murphy, E., Balz, M. and Kaplan, J. A multimodal approach for community-based aphasia group therapy. College of Health and Rehabilitation Sciences, Boston University.

∗ Richman, M., Redmond, S. and Williamson, D. The ABC´s of group treatment for aphasia. Stroke Comeback

BY:  

 

Lina  Moncada  

LANGUAGE  AND  COMMUNICATION  II  

Teacher:  Marcela  Maldonado