Progress Memo 3

To Whom It May Concern:

Since the last submission of the notebook I have learned more about phonology and writing. I have learned that target selection is very important in treatment and that in order to provide efficacious treatment it is best for a clinician to choose more complex targets. I have furthered my learning into how phonology and language are linked and that it is important to consider language acquisition when treating a phonological client. I have learned how to use transitions more effectively in my writing. I learned that hedging makes writings less credible and that as a writer you should avoid hedging. I have also learned how to make my writings more precise. This is what I have learned.

Applying what I have learned since the last submission has not been an easy task. I now find myself transitioning more in my papers which is improving the flow. But sometimes I become caught up in the transitions and have to change wording to improve the flow. I think that I have learned to transition and that I am still developing this skill. I have learned how to review my writing to make sure it is more precise. This is how I have applied my learning.

My learning in this class has helped me become a better clinician. I am now aware of many different treatment approaches that could be used with a client who has a phonological disorder. The class has also immensely improved my writing skills. I think that I am a stronger writer because of this class. The class has also given me the opportunity to state my positions on issues in the field, which has improved my confidence and made me more comfortable as both a student and a clinician. This is what my learning means to me.

Currently, I do believe I am obtaining the information without any trouble. However, I think that I will better understand all of my learning when class furthers the discussion into theory. I do not have any questions at this time. Thank you for your time.

The Naturalist’s Journal Reaction Log

April 25, 2008

Fulwiler, T. & Hughes, J. The naturalist’s journal. Retrieved April 25, 2008 from

http://www.uvm.edu/~fntrlst/journalmonograph.pdf .

Record	React
Main Point: The purpose of the monograph is to provide the reader with an idea of what a journal is and how one should organize a journal.	Relevance: The topic is not directly related to the field but the thoughts on recording data are relevant. As clinicians we may not realize it but out SOAP notes are very similar to a journal. We record behaviors and keep data for a particular client and they act as our records of what happened that particular day. We can go back and look at a SOAP note from the beginning of the semester and note the progress a client has made. Even though we may not know it, we are journal writers in our own right.
Concepts: The main concepts presented in this piece include: · Organization is important when keeping a journal. · A journal should be sequenced. · Journals can be used as a reflective source of one’s work.	Connections: Currently, I do not journal for myself. However, I do journal every time I write a SOAP note. I consider the notes to reflect my client and their work. I find that keeping good SOAP notes allow me to look back on my experiences with my client when it is time to complete the semester and write a progress report. Keeping my notes organized and sequenced is key in this process and it helps me gather my thoughts when writing the final report for the semester.
Summarize: The authors provide the reader with suggestions for keeping a journal as well as information on the types of journals an individual can keep. The article gives examples of the different types of journal writing.	Confusions: Would you consider our SOAP notes a field journal?

Reaction Log Theory

April 24, 2008

Barlow, J. (2001). Recent advances in phonological theory and treatment. Language, Speech,

and Hearing Services in Schools, 32, 225-228.

Barlow, J. (2001). Recent advances in phonological theory and treatment. Language, Speech,

and Hearing Services in Schools, 32, 295-297.

Barlow, J. (2002). Recent advances in phonological theory and treatment: Part II. Language,

Speech, and Hearing Services in Schools, 33, 4-8.

Record	React
Main Point: The purpose of the articles is to inform the reader of recent advances in phonological theory and treatment.	Relevance: The articles are relevant to the field of speech-language pathology because the author is describing advances in theory and treatment of phonological disorders. The articles are particularly useful to practicing clinicians who have clients with phonological disorders. The information presented in the articles could help a clinician determine an appropriate treatment approach for therapy with a client who has a phonological disorder.
Concepts: The main concept presented in the articles is that phonology is linked to language therefore phonology should be viewed along with language acquisition.	Connections: As we learn in undergraduate coursework phonology is a part of our language system. Therefore, as clinicians we need to view the overall language system when a phonological disorder is present. It has been found that there is a high incidence of language and phonological disorders co-occurring. This is not surprising to me since we learn that phonology is part of our language system. However, I do think at times we forget the connection and need to be reminded of it reading these articles reminded me of that simple fact.
Summarize: The articles provide connections and an overview of treatment and theory. The articles comment on how phonology and language are linked and that this connection should be taken into consideration when developing a treatment plan.	Confusions: I am still not clear on all of the theories. However, it may just be the intimidation of the word theory that is scaring me into thinking that I am not sure about the topic.

Reaction Log 11: Treatment

April 1, 2008

Williams, A.L. (2000). Multiple oppositions: Theoretical foundations for an alternative

contrastive intervention approach. American Journal of Speech-Language Pathology, 9,

282-288.

Record	React
Main Point: The purpose of the article is to describe multiple oppositions approach as an alternative contrastive intervention approach and to provide information about the development and the theory driving the approach.	Relevance: The article is relevant to the field of speech-language pathology because the author is describing an alternative approach to use when treating a client with a severe phonological disorder.
Concepts: The main concepts presented in this article include: · The multiple opposition approach is grounded on the premise that the systematic level is key in phonological intervention. · Children with limited sound systems collapse phonemes as a strategy. · Multiple oppositions approach directs intervention to approach the entire rule the child is not using.	Connections: I recently completed a diagnostic and recommended that the child begin multiple oppositions therapy because of her systematic sound preference. After researching the methods I believed that this would be best in building her phonological system. I think that this approach is a great approach to use with children who have very limited sound intervention. I like that the therapy is focused on the client learning the rule that they are not using instead of just covering-up the problem. I believe that this is an effective and efficient strategy to use when treating a client with a severe phonological disorder.
Summarize: The author presents multiple oppositions as an alternative contrastive treatment approach. By using larger treatment sets to target incomplete or collapsed phonological systems the clinician is able to teach the underlying rule that the client is not aware of. This provides the client with phonological knowledge not just cover-up to make the sound correct.	Confusions: Would you recommend multiple or maximal oppositions for a client with a systematic sound preference? I believe multiple oppositions would be best. Do you agree?

Reaction Log 10: Treatment

March 18, 2008

Williams, A.L. (2000). Multiple oppositions: Case studies of variables in phonological

intervention. American Journal of Speech-Language Pathology, 9, 289-299.

Record	React
Main Point: The purpose of the article is to present evidence found in case studies of variables in intervention that could be applied to the practice of treating phonological disorders and to provide information on multiple oppositions treatment.	Relevance: The article is relevant to practicing speech-language pathologists, graduate clinicians, and students studying communication disorders because it provides information about treating children with moderate to profound phonological impairments. Clinicians can read this article and apply to practice. The article is also relevant to researchers because the data collected could be examined and further investigated in order to establish a clinical framework for the treatment of phonological disorders.
Concepts: The main concept of the article is that multiple oppositions therapy triggers more change in the phonological system.	Connections: I have never used multiple oppositions therapy in the treatment of a phonological disorder, however, after reading this article I would consider this therapy approach. The approach selects targets based upon how the targets will help reorganize the system and promote system-wide change. This is a step away from the traditional method of target selection. I think that this approach to therapy could promote much change to a phonological system of a child with a systematic sound preference. Providing several contrast would help to increase the child’s inventories providing for more change within the system. This would be an efficacious approach to use with such a child.
Summarize: The author of the article supports using multiple oppositions in the treatment of moderate to profound phonological disorders. The beginning of treatment and the determination of a treatment approach is target selection. In order to better serve clients we must select targets that will be conducive to the approach we plan to use. Using a multiple oppositions approach will offer efficacious treatment to a child with a moderate to profound phonological disorder.	Confusions: Do you believe that this would be the best approach to use with an individual with a systematic sound preference? If not, which approach would you suggest?

Reaction Log 9: Treatment

March 18, 2008

Tyler, A., Lewis, K., & Welch, C. (2003). Predictors of phonological change following

intervention. American Journal of Speech-Language Pathology, 12, 289-298.

Record	React
Main Point: The purpose of the article is to provide the reader with information regarding what predictor or combination of predictors variables best facilitate change in a phonological system.	Relevance: The article is relevant to practicing speech-language pathologists, graduate clinicians, and students studying communication disorders because it provides information about variables in treatment that will best predict change to a phonological system. Knowing the predictors will allow clinicians to choose better targets and treatment approaches to therapy. The impact of the article is that it can help outline more efficacious treatment for clients who have phonological disorders.
Concepts: The main concepts presented in this article include: · Of the predictor variables examined in this study the one that showed most shocking results was error consistency. The results indicated that children with inconsistent errors demonstrated more change to the system than children with consistent errors. · More research needs to be performed to help determine more predictors of phonological change.	Connections: I found the results concerning consistency of errors most surprising. Using the clinical knowledge that I have gained a clinician would think that if the error was consistent then it would be easier to change through the intervention process. But as the study indicated further research needs to be complete to determine the overall significance of error consistency as a predictor of phonological change. In this study it was thought to be a moderately strong predictor that should be considered in clinical application. To increase our knowledge about predictors of phonological change more research needs to be performed and the results need to be reported.
Summarize: The study examined the predictor variables of chronological age, inventory size, error consistency, and expressive language to the criterion variable and how these variables influenced phonological change. The study found that error consistency was a moderately strong predictor of phonological change and therefore, should be examined further and possibly used in clinical application of phonological treatment.	Confusions: Any ideas on why clients with inconsistent errors saw greater change in the system? I had one idea that the sound may be emerging and the client may be learning the rule therefore change would be easier when therapeutic intervention was present. What are your thoughts on this?

Reaction Log 8: Treatment

March 17, 2008

Rvachew, S. & Nowak, M. (2003). Clinical outcomes as a function of target selection strategy: A response to Morrisette and Gierut. Journal of Speech, Language, and Hearing

Research, 46, 386-390.

Record	React
Main Point: The purpose of the article is to respond to the claims made by Morrisette and Gierut (2003) about the authors’ research supporting selecting more complex targets, when Rvachew and Nowak (2001) originally reported the opposite of this claim.	Relevance: The article is relevant to practicing speech-language pathologists, graduate clinicians, and students studying communication disorders because it provides information about target selection and the efficacy of selecting complex versus less complex targets. The authors of this article are responding to claims made by other researchers about their research. The authors want to provide information from their point of view in order to allow clinicians to make decisions based upon the evidence available about selecting targets for phonological therapy.
Concepts: The main concept of this article is that selecting less complex targets will allow the client to make greater progress toward mastery of the selected target, therefore it is better to select less complex targets will result in superior outcomes.	Connections: I disagree with the authors claims and believe that superior outcomes will result when more complex targets are selected. Gierut (2001) found that the selection of more complex targets resulted in system-wide change to the phonological system. For change to occur to the system without having to target every error and just selecting complex sounds allows treatment to be more efficient and more effective, which is the goal of a clinician. Although Rvachew and Nowak (2001) claim that parent satisfaction was greater for the children who had therapy using traditional selection I believe that the ultimate outcomes of therapy would be the opposite of this claim. I also do not believe that targets should be selected just to satisfy the parent. I believe that the targets selected for therapy should be selected based on the individual and that they should help promote the most change to the phonological system in the shortest amount of time.
Summarize: Rvachew and Nowak (2003) believe that the research performed in 2001 proves that clinicians should select less complex targets in order to provide efficacious treatment and the authors refute the claims made by Morrisette and Gierut (2003). However, the evidence presented does not seem to have as much weight as the evidence presented by Morrisette and Gierut (2003).	Confusions: At this time I am not confused. I have even taken a position on this which I am sure is relevant in my writing.

Gierut, J.A. (2001). Complexity in phonological treatment: Clinical factors. Language, Speech, and Hearing Services in Schools, 32, 229-241.

Morisette, M. & Gierut, J. (2003). Unified treatment recommendations: A response to Rvachew and Nowak (2001). Journal of Speech, Language, and Hearing Research, 46, 382-385.

Rvachew, S. & Nowak, M. (2001). The effect of target-selection strategy on phonological learning. Journal of Speech, Language, and Hearing Research, 44, 610-623.

Reaction Log 7: Treatment

March 15, 2008

Rvachew, S. & Nowak, M. (2001). The effect of target-selection strategy on phonological

learning. Journal of Speech, Language, and Hearing Research, 44, 610-623.

Record	React
Main Point: The purpose of the article is to inform the reader of the results of a study that was performed to determine if the traditional or nontraditional approach to target-selection was more effective in phonological learning.	Relevance: The study is relevant to practicing speech-language pathologists, graduate clinicians, and students studying communication disorders because it provides information about target selection. The study found that there was no difference in generalization between the two groups, however, parent satisfaction was greater for children in the traditional group. This is thought to be due to quicker production changes on the surface to the targeted sounds. However, how can a clinician be sure that the child is learning the rule and that we are not just providing cover-up for the underlying problem of knowledge.
Concepts: The main concept presented in this article is that more improvement will be made and parents will be more satisfied when an early developing less complex target is selected for therapy.	Connections: Being a student clinician and having worked with children who have phonological disorders, I know that success is important and it is nice to show progress on goals, however is choosing the least complex target the most efficacious. Even though the study shows that the traditional group progressed and the parents were more satisfied, how much of the phonological system was changed? When selecting more complex targets, Gierut (2001) found that selecting these targets allowed for system-wide change. Thus, providing more efficacious treatment. The children were obtaining knowledge not just covering-up the underlying problem. Although the parents were more satisfied with the surface results of the traditional treatment I think that the results of the more complex targets overall would make the parents happier because the overall system would make changes in a more timely manor as opposed to selecting the least complex and only seeing changes to the particular target selected.
Summarize: Contrary to Gierut (2001) the researches found that it was better to choose sounds that are less complex in order to provide the parents with satisfaction. The researchers found that using traditional methods showed more changes to the sounds being targeted versus the nontraditional method.	Confusions: Do the researchers actually think that saying the parents were more satisfied with the treatment results is a better way to judge the efficacy of the treatment provided?

Gierut, J.A. (2001). Complexity in phonological treatment: Clinical factors. Language, Speech, and Hearing Services in Schools, 32, 229-241.

Reaction Log 6: Treatment

March 15, 2008

Morisette, M. & Gierut, J. (2003). Unified treatment recommendations: A response to Rvachew and Nowak (2001). Journal of Speech, Language, and Hearing Research, 46, 382-385.

Record	React
Main Point: The purpose of this article is to provide a response to research performed by Rvachew and Nowak (2001) that disputed findings of a study performed by Gierut in 2001 that found that selecting more complex targets allowed for system wide change and therefore, was a more efficacious approach to treatment.	Relevance: The article is relevant to practicing speech-language pathologists, graduate clinicians, and students studying communication disorders because it provides information about target selection and the efficacy of selecting complex targets. The findings of the study show that choosing more complex targets when treating a phonological disorder will result in more change to the system and will provide more efficacious treatment for the client. This is opposing the results previously published by Rvachew and Nowak (2001).
Concepts: The main concept of this article is that it is more efficacious and more changes are seen when complex targets are selected for treatment when treating a client with a phonological disorder.	Connections: Our goal as clinicians is to provide the most efficacious treatment, and although choosing less complex sounds would provide for advancement of the single sound choosing a more complex target allows for system wide change. Whereas, Rvachew and Nowak (2001) base there claims for choosing less complex sounds on parent satisfaction I think choosing more complex sounds will allow for more change and lead to greater satisfaction of the client. As clinicians we need to think about the efficaciousness of our treatment approach not just pleasing the client’s parents.
Summarize: The article provides ample information on why complex targets should be selected when treating a phonological disorder. The results of the studies speak volumes to practicing clinicians. To provide more efficacious treatment clinicians need to choose more complex targets for treating phonological disorders.	Confusions: Rvachew and Nowak (2001) base their argument for choosing least complex sounds on the satisfaction of the parent, since their research has been presented has there been anymore research on parent satisfaction of different treatment methods based on overall change to intelligibility of a child with a phonological disorder? I think that the results of such a study would weaken Rvachew and Nowak (2001) argument for choosing less complex phonemes in treatment.

Gierut, J.A. (2001). Complexity in phonological treatment: Clinical factors. Language, Speech,

and Hearing Services in Schools, 32, 229-241.

Rvachew, S. & Nowak, M. (2001). The effect of target-selection strategy on phonological

learning. Journal of Speech, Language, and Hearing Research, 44, 610-623.

Reaction Log 5: Treatment

March 13, 2008

Gierut, J.A. (2001). Complexity in phonological treatment: Clinical factors. Language, Speech,

and Hearing Services in Schools, 32, 229-241.

Record	React
Main Point: The purpose of the article is to provide information on selecting complex targets for the treatment of functional phonological disorders.	Relevance: The article is relevant to speech-language pathologists, graduate clinicians, and undergraduate students in communication disorders because it discussed target selection when treating a client with a functional phonological disorder. The targets selected in clinical practice for this study were based upon: consistency of the error, normative age of acquisition, and number of errors to be treated. The article reveals that choosing more complex targets will result in greater change in the phonological system ultimately providing more efficacious treatment to the client. I found that this article would be helpful when selecting targets for a potential client with a phonological disorder.
Concepts: The main concept of this article is that selecting more complex targets will allow for greater changes in the phonological system, which will allow clinician’s to provide more efficacious treatment to clients with functional phonological disorders.	Connections: Having encountered individuals with functional phonological disorders and reflecting on my experience after reading this article I realized the importance of target selection and treatment. I now think that instead of doing what was recommended prior to my having the client I should have researched treatment approaches and decided on the best targets for the particular client. Gierut (1998) determined that the most efficacious treatment will be dependent on the client and the type and amount of errors the client has. I think that treatment begins with target selection and that the treatment approach used will be based upon the targets selected and after reading the article I think that it is best to select more complex targets in order to provide more efficacious treatment to the client and allow for more change within the phonological system.
Summarize: The evidence presented in this article suggests that as clinicians we should choose more complex targets when treating clients with functional phonological disorders in order to promote more change to the phonological system. Therefore, allowing clinicians to provide more efficacious treatment to the client.	Confusions: At this time I am not confused about the material I read in this article. It was evident that selecting complex targets would allow for more change and more efficacious treatment.

Gierut, J.A. (1998). Treatment efficacy: Functional phonological disorders in children. Journal

of Speech, Language, and Hearing Research, 41, S85-S100.