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1. Discuss the theoretical rationale underlying the selection of the goals and the therapy approach(es) (in other words, linking the intervention to the individual case through theory)

2. Discuss the therapy approaches or programme, and discuss how learning will be facilitated: i.e. the use of techniques/procedures (e.g. cueing, recasting, scaffolding frameworks, increase/decrease steps) ?

3. Provide a discussion of the evidence base / efficacy research behind the selected therapy approach(es)

4. Address measurement issues - describe and provide information on methods of recording outcomes and progress (you may include sample recording sheets, checklists, perceptual rating scales etc. in an appendix outside of the page count if this clarifies your planning – but this will not be marked).

5. Outline and discuss appropriate methods of analysis to measure progress and evaluate effectiveness using the data you plan to collect

Manifestations of Speech and Language Disorders

Speech and Language disorders can occur due to various complications including hearing impairments, autism, and articulation issues. Language disorders exist in three forms that include receptive, expressive, and mixed language problems (McIntyre, Laurie-ann, Bidonde, Boden, & Doi, 2017). Children with responsive language problems cannot understand what their teachers are saying in class. Additionally, students with significant issues cannot express their ideas and thoughts in front of others. Those with a mixture of the two can neither understand the expression of others nor express themselves in public. Language and speech disorders are either developmental or acquired (Boyce, Kilpatrick, Reilly, Da Costa, & Morgan, 2018). An acquired disorder occurs after the victim has encountered a neurological illness. On the other hand, developmental speech disorders are common in young ones. The two types of disorders limit the ability of a student to showcase basic literacy skills.

This paper will summarise the Client's information. The patient expresses slow literary skills due to the ear infection at his early stages of development. It will also discuss the theoretical rationale of the complication. The contents of the paper will explore the various manifestations of the condition like receptive, expressive, and cognitive difficulties. The essay will also discuss the treatment goals which include rectifying the receptive, expressive, cognitive, fluency, and vocabulary difficulties. The paper will then turn its focus into therapy programs which include educational, family, communication, and behaviour therapy. The essay will proceed by reviewing the efficacy of the discussed therapy programs. It will also measure and analyse the interventions. Finally, it will address the interventional activities towards recovery.

Paul has speech and spelling problems at school. The student had numerous ear infections in the first phase of his life. The infections are the key causes of Paul’s slow literary skills and language development. The parents ensured that the caregivers inserted grommets in his ears to solve the language problems. However, Paul still finds difficulties in explaining the happenings around him. Additionally, he enjoys playing with his friends but talks on a few occasions. He encounters difficulties when pronouncing a word like ‘King's' which he pronounces as ‘King'. When the teacher asks him to pronounce the sentence ‘will be sliding', he only captures and pronounces ‘sliding'. The sum of his WC-R and WC-E scores amount to 26 which is way below the desirable scores for an average grade one student.

Paul also has poor scores in the receptive and the expressive subtests. He scores 9 points in each of the three receptive subtests. He has a score of 5 in each of the word structure, recalling sentences, and expressive vocabulary subtests. However, Paul is good at math and sports. The client cannot pronounce long sentences. He also has a problem in reading and spelling words. The client cannot re-tell a story especially if the piece of art is composed of long sentences. Paul also has a phonological problem as he cannot distinguish the sound of rhyming words. According to the data, he has an average score in rhyme detection where he gets two out of four. However, the client has poor scores in rhyme production as he gets one out of four sounds right. He also finds difficulties in reading and spelling Non-word readings.

Treatment Goals of Speech and Language Disorders

Speech and spelling disorders hinder the development of children at the learning institutions (Jacobs, Flanagan, & Alfonso, 2017). The complications can either be primary or secondary depending on the causes. Primary speech and spelling disorders lack a documented aetiology; however, secondary disorders results from hearing impairments, autism, among other complications (Harrison, McLeod, S., McAllister, & McCormack, 2017). Paul's condition is a primary condition as it is due to ear infections in his early stages of development. The patient has a wide range of difficulties that call for an efficient management plan. The challenges include receptive, expressive, cognitive, fluency, and articulation problems. Responsive disorders limit the ability of an individual to process or understand a language. Therefore, the patient grasps little knowledge from the classroom. Expressive disorders hinder patients from using language appropriately in social set-ups. Paul cannot explain the happening surrounding him when playing with other children.

The patient also has cognitive disorders which make him have the vocabulary and phonological difficulties in expression. Cognitive complications impair the attention, memory, perception, and regulation of the client (Carrigg, Parry, Baker, Shriberg, & Ballard, 2016). Additionally, communication disorders limit the problem solving skills and organisational levels of the victim. Articulation disorders limit the client from pronouncing words correctly (Hassan, 2015). This is evident as Paul says ‘fast' instead of ‘faster' and ‘blow' instead of ‘blew'. The parents of the parents also admit that the child has fluency disorders. The complications make victims to prolong the spelling of different words. Paul used to pronounce ‘Mumma' and ‘dadda' thereby prolonging letters ‘m' and‘d’ respectively. The following difficulties call for goals to solve the patient’s condition. Treatment approaches and goals will target correcting the phonological, receptive, expressive, cognitive, fluency, articulation, speech, and other difficulties.

The goals of treatment are to correct the speech and language difficulties facing the patient. The objectives include rectifying the receptive, expressive, cognitive, fluency, and articulation difficulties. Additionally, the long-term treatment intends to solve the phonological difficulties facing Paul. The speech and language therapist need to implement the articulation and other therapies to address Paul's problems (Dodd, Reilly, Ttofari Eecen, & Morgan, 2018). During articulation sessions, the therapist should ask the patient to pronounce given sounds and correct the ones wrongly pronounced by the child. The therapy should happen amid play between the client and the specialist. Lovaas program is also a suitable approach to solve the speech difficulties (Wood, Christian, & Sampson, 2018). The program should take fifty hours per week and should involve training Paul on basic skills like imitations. The program improves the social skills and the use of language by the child.

Efficiency of Therapy Programs in Speech and Language Disorders

The speech and language pathologist should encourage the teacher to read various sentences aloud to enhance the receptive capabilities of the student (Lim, McCabe, & Purcell, 2017). The parent should also work closely with the teacher to find long-lasting solutions to the problems facing the client. The teacher should read sentences slowly and repeatedly due to the hearing difficulties. The parent should also create extra time to help the child in improving his speech and reading skills. The reading environment is also a factor for auditory disorders. The teacher should ensure that the school compound is quiet for a conducive learning environment. The parent should create reading time on a daily basis for the child. Incorporating plays and games also improve the learning ability of children. Therefore, the tutors should devise relevant plays to help in speech and language.

Communication and Behavior Therapies: the programs train children on how to communicate with one another (Reilly, McKean, Morgan, & Wake, 2015). Additionally, the therapies teach young ones on appropriate actions at the social fronts. Paul has difficulties communicating with other children when they are playing; therefore, the remedy is suitable for his condition.

Educational Therapies: The client requires a different system of education from the other students to improve his literary skills (Watt, & White, 2018). The parents should recruit experts like vocabulary and speech therapists to train Paul. Educational therapies should aim to improve the behaviour, communication, and social skills of the client. The student requires individualised and intensive attention from both the teachers and the parents. A recent study has indicated that specialised care towards such students improves their progress in school.

Family Therapy: Parents and the rest of the family should interact and play with the child in a manner that improves the social skills of interaction (Thompson, McFerran, & Gold, 2014). Paul experiences limitations in expressing how to play a game or talk about it. Therefore, the family members should sharpen his social and interaction skills at home.

Additional Remedies: speech therapy improves the client’s communication skills. An occupational therapist can help the client on how to interact with others both at school and at home (Glover, McCormack, & Smith-Tamaray, 2015). The case study information also indicates that Paul had an ear infection at a tender age. Therefore, the caregivers should recommend an appropriate medication to correct the hearing complication. However, the caregivers should be cautious of the type of drugs that they prescribe to the patient. Certain drugs possess undesirable side effects to the child; thus the specialists should stick to the non-medication remedies.  

Communication and behaviour therapies improve the communication skills and the behaviour of children with speech and communication impairments. A recent study has indicated that children who have undergone successful treatments have improved interaction skills. Behaviour therapies sharpen the behaviour of children; thus improving their interaction with other children. Educational treatments enhance the performance of students at the literary front (Voelmle, & Storkel, 2015). The teachers should separate the students with language and communication difficulties from the rest of the learners. Receiving specialised education sharpens the skills of the students with complications; hence bringing them at par with their mates. The therapies require the trainers to read sentences loudly to the student. Additionally, the teacher should repeat the sentences to enhance reception by the student. A recent investigation has retaliated that educational therapies sharpen both speech and language skills.

Family therapies also improve the learning capabilities of the student; since the family is the first teacher (Wallace et al., 2015). Playing and interacting with the child train them on the appropriate social skills. Therefore, such children excel in interacting with the others both at school and at home. The family members should train their child in various aspects like vocabulary amid a game environment. Specialists should educate the family on the appropriate games to boost the vocabulary and speech of the child. Speech therapists specialise in training children on practical communication skills (Eadie et al., 2015). Auditory complications at birth can interfere with the speech of the victims. Therefore, the parent of a child with literary problems should seek the services of the specialist to sort out the communication difficulties. Medications are the last line of speech and language remedies due to side effects like dizziness, nausea, and vomiting.

Paul has a problem in pronouncing and spelling various vocabularies as mentioned in the case information and also in the assessment data. To measure the effectiveness of the various therapies, the teacher should note down a few simple words and ask Paul to pronounce them. Proper pronunciation and spelling by the student indicate that the remedies were successful. However, failure of the student to get the spelling right suggest that the solutions were inadequate. Therefore, the various stakeholders should revisit the interventions and make the necessary changes. The client also has difficulties interacting with the other children when they are playing. The parents have detected the social interaction difficulties at home while the teachers have identified the issue at school. Both the teachers and the parents should observe the student's level of communication when playing with the others (Davies, Marshall, Brown, & Goldbart, 2017). An improved level of social interaction indicates that the remedies were successful and vice versa.

The client also had difficulties in retelling narratives as he cannot reproduce the exact words from the narrator. The teacher should construct a short narrative and tell it to Paul slowly. The trainer should be loud and repeat the sentences to ensure that the client has received the message. The storyteller should then ask Paul to re-tell the story. The ability of Paul to reproduce the sentences indicates that the treatment therapies were effective. However, if the client cannot speak the exact words of the narrator, then the therapies were ineffective. The client also has difficulties in rhythm production and detection. The communication specialist should write two rhyming words and ask the client to produce the third word (Gregory, & Bryan, 2015). If Paul can complete the rhyming series, then the communication therapy was adequate. However, the inability to achieve the rhyme scheme indicates the shortcomings of the therapies.

 The first activity in improving the speech and language capabilities of the client is talking and playing with the child by the family members. Playing with the client improves his interaction skills with the others both at school and at home. Constant talking with Paul improves his vocabulary and pronunciation skills. The second activity is to expose the client to books, pictures, objects to boost his language prowess. Additionally, the specialist should model the correct vocabulary to expand the literary capabilities of the client. Creating accurate grammar also improves the pronunciation skills of the child. The teacher should always repeat sentences to strengthen retention (Volden et al., 2017). Repeating sentences and phrases sharpen the receptive skills of students with literacy difficulties.

 The parents and the teachers should instil a culture of constant reading for the student (Daniel, & McLeod, 2017). The parents should create a minimum of two reading hours per day. Recent research has indicated that the reading culture improves language capabilities. The next activity involves reading the sentence aloud to the student. The ear infection limits the ability of Paul to perceive low tones. Therefore, high pitched sounds can help the client to improve on various aspects like vocabulary. The next activity is for the teacher to conduct leaning slowly. A quick process of learning prevents the student from perceiving all the words in a given sentence. Speech training is the final activity of improving the literary capability of the client. The training enables the student to express himself in front of the others.

Conclusion

Speech and Language difficulties interfere with the performance of students in the classroom. Receptive problems prevent the student from understanding the teachings from the trainer. Expressive complications limit the ability of the client to express ideas and thoughts in front of people. The short and long-term treatment goals involve rectifying the receptive, cognitive, and expressive difficulties. Other goals include amending the fluency and articulation difficulties. Relevant therapy programs assist in redressing the language and speech complications. The therapies include communication, behaviour, educational, and family interventions. Communication remedies enable the client to interact freely and express themselves in front of others. The family should play with the client to improve literacy skills. Additionally, proper educational strategies can improve the language capabilities of the client.

Recent research has indicated that the above remedies solve the language and speech complications that are common in children. Communication and behavioural remedies improve both behaviour and communication skills. Family therapy improves the social interaction skills among the children. Educational therapies enhance the performance of student at the literary front. Specialists should measure and analyse the efficacy of the therapy programs. The improvement of the client's social skills indicates that family therapies are effective. The improvement of the student at the literary front showcases the effectiveness of the educational remedies. On the other hand, the ability of the client to express themselves indicates the success of the communication remedies. Activities like talking and playing with the child improve their social interaction skills.  

References

Boyce, J. O., Kilpatrick, N., Reilly, S., Da Costa, A., & Morgan, A. T. (2018). Receptive and expressive language characteristics of school?aged children with non?syndromic cleft lip and palate. International journal of language & communication disorders, 53(5), 959-968.

Carrigg, B., Parry, L., Baker, E., Shriberg, L. D., & Ballard, K. J. (2016). Cognitive, Linguistic, and Motor Abilities in a Multigenerational Family with Childhood Apraxia of Speech. Archives of Clinical Neuropsychology, 31(8), 1006-1025.

Daniel, G. R., & McLeod, S. (2017). Children with speech sound disorders at school: Challenges for children, parents and teachers. Australian Journal of Teacher Education (Online), 42(2), 81.

Davies, K. E., Marshall, J., Brown, L. J., & Goldbart, J. (2017). Co-working: Parents’ conception of roles in supporting their children’s speech and language development. Child Language Teaching and Therapy, 33(2), 171-185.

Dodd, B., Reilly, S., Ttofari Eecen, K., & Morgan, A. T. (2018). Articulation or phonology? Evidence from longitudinal error data. Clinical Linguistics & Phonetics, 32(11), 1027-1041.

Eadie, P., Morgan, A., Ukoumunne, O. C., Ttofari Eecen, K., Wake, M., & Reilly, S. (2015). Speech sound disorder at four years: prevalence, comorbidities, and predictors in a community cohort of children. Developmental Medicine & Child Neurology, 57(6), 578-584.

Glover, A., McCormack, J., & Smith-Tamaray, M. (2015). Collaboration between teachers and speech and language therapists: Services for primary school children with speech, language and communication needs. Child Language Teaching and Therapy, 31(3), 363-382.

Gregory, J., & Bryan, K. (2015). Speech and language therapy intervention with a group of persistent and prolific young offenders in a non-custodial setting with previously undiagnosed speech, language and communication difficulties. International Journal of Language & Communication Disorders, 1-14.

Harrison, L. J., McLeod, S., McAllister, L., & McCormack, J. (2017). Speech sound disorders in preschool children: Correspondence between clinical diagnosis and teacher and parent report. Australian Journal of Learning Difficulties, 22(1), 35-48.

Hassan, A. E. H. (2015). The effectiveness of Treatment Approaches Based on Articulation Therapy to Reduction Degree of Speech Disorders. International Journal for Innovation Education and Research, 3(8).

Jacobs, K. E., Flanagan, D. P., & Alfonso, V. C. (2017). Evidence-Based Assessment and Intervention for Specific Learning Disability in School Psychology. In Handbook of Australian School Psychology (pp. 145-171). Springer, Cham.

Lim, J., McCabe, P., & Purcell, A. (2017). Challenges and solutions in speech-language pathology service delivery across Australia and Canada. European Journal for Person Centered Healthcare, 5(1), 120-128.

McIntyre, L. J., Laurie-ann, M. H., Bidonde, J., Boden, C., & Doi, C. (2017). Receptive and expressive English language assessments used for young children: a scoping review protocol. Systematic reviews, 6(1), 70.

Reilly, S., McKean, C., Morgan, A., & Wake, M. (2015). Identifying and managing common childhood language and speech impairments. BMJ, 350, h2318.

Thompson, G. A., McFerran, K. S., & Gold, C. (2014). Family?centred music therapy to promote social engagement in young children with severe autism spectrum disorder: A randomised controlled study. Child: care, health and development, 40(6), 840-852.

Voelmle, K., & Storkel, H. L. (2015). Teaching new words to children with specific language impairment using interactive book reading. Perspectives on Language Learning and Education, 22(4), 131.

Volden, J., Dodd, E., Engel, K., Smith, I. M., Szatmari, P., Fombonne, E., ... & Vaillancourt, T. (2017). Beyond sentences: Using the Expression, Reception, and Recall of Narratives Instrument to assess communication in school-aged children with autism spectrum disorder. Journal of Speech, Language, and Hearing Research, 60(8), 2228-2240.

Wallace, I. F., Berkman, N. D., Watson, L. R., Coyne-Beasley, T., Wood, C. T., Cullen, K., & Lohr, K. N. (2015). Screening for speech and language delay in children five years old and younger: a systematic review. Pediatrics, 136(2), e448-e462.

Watt, A., & White, S. (2018). Efficacy of group versus individual therapy for advancing receptive and expressive language development for children aged 6–12 years within community settings: A critically appraised topic. Evidence-Based Communication Assessment and Intervention, 1-18.

Wood, S., Christian, M. P., & Sampson, A. (2018). Audit of outcomes following a community?based early intensive behaviour intervention program for children with autism in Australia. Australian Journal of Psychology, 70(3), 217-224.

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