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Crosbie, S., Holm, A. & Dodd, B. (2005). Intervention for children with severe speech disorder: A comparison of two approaches. International Journal of Language and Communication Disorders, 40, 467 - 491.
Dodd, B., Holm, A., Crosbie, S., & McIntosh, B. (2006). A core vocabulary approach for management of inconsistent speech disorder. Advances in Speech-Language Pathology, 8(3), 220 - 230.
Bowen, C. (2012, August 7). Core Vocabulary Therapy. Speech-Language Therapy . Retrieved April 18, 2013, from http://speech-language-therapy.com/index.php?option=com_content&view=article&id=74:co
Select 50 Core Vocabulary Words
Therapy Implementation:
10 words a week/2x week sessions
Elicit consistent production
Example of selected core vocabulary words
fishing, dinosaur, ANZAC Parade, soccer, school, animals, Timothy, Blackheath, hungry, drink, knife, Angelo, thank you, biscuit, swimming, broke, fork, listen, uncles, toilet, please, heavy, computer, book, Delia, Jayden, finished, school, lunch box, help, friends, Anthony, cars, hand towel, Foster, stop, Auntie Sarah, pirate, Milo, Mrs Tonelli, hot chocolate, Mrs Joseph, reader, guitar, Sydney, Blackheath Station, Granny, jetty, Barack Obama (‘yes we can!’)
Core Vocabulary Therapy begins with the child, parents, teacher and other caregivers selecting, with the therapist’s help if required, 50 words that are functionally ‘powerful’ for the child, and ‘mean something’ to him or her, such as, names: family, friends, teacher, pets; places: school, library, a park, swimming, McDonalds; functional words: please, thank you, toilet; favorite things: sport, superheroes, games and characters.
Ten words are selected from the list and best production is drilled in twice-weekly sessions (ideally). At the end of the week the child produces the 10 words three times. Words produced consistently are removed from the list of 50 words. Words that are inconsistently produced remain on the list from which the next week’s 10 words are randomly chosen.
To elicit consistent production, the child is asked to produce each target word three times. Based on production accuracy, target words are selected for the next session. Fun and motivating ways to go about this step include using a word wall or making drill-play part of a game the child enjoys.
It is important that there is carryover in the home so that the child's environment is cohesive and conducive to the best therapy outcomes. Providing the child with book of their words to use outside of therapy is one way to help. Make sure the parents/caregivers are on the same page!
The Core Vocabulary Approach is intended for children with Inconsistent Speech Disorder.
Hypothetically, the underlying deficit of inconsistent speech disorder is a phonological planning deficit, not a cognitive-linguistic deficit, and most affected children probably fall in the severe Speech Sound Disorder range.
The rationale for the approach is that different parts of the speech processing chain respond differently to therapy targeting different processing skills, and that treatment that targets the speech-processing deficit underlying the child’s speech disorder will result in system wide change.
Following Independent and Relational Analysis, an Inconsistency Assessment is administered.
Twenty-five pictures are named on three separate occasions in one session, ensuring that the same lexical items are elicited within an identical context. The productions are compared in order to calculate an inconsistency score.
Children are deemed to have Inconsistent Speech Disorder if 40% or more of the words are produced variably; and Consistent Speech Disorder if they exhibit two or more atypical patterns and an inconsistency score below 40%.
The core vocabulary approach targets children with severe, but inconsistent speech sound production. Researchers hypothesize that the reason for such unstable phonological systems reflects a deficit in phonological planning (phoneme selection and sequencing).
Although these inconsistencies present in childhood apraxia of speech as well, the core vocabulary approach is the "treatment of choice" for children with inconsistent speech sound productions who may be resistant to contrast treatment or traditional therapy.
Core vocabulary treatment results in system-wide change by improving the consistency of whole-word production and addressing speech processing deficits.
Specifically in terms of short-term goals:
Rather than focusing on individual speech sounds, a major short-term therapy goal is to build a functional vocabulary for the child. Oftentimes, there are significant intelligibility problems, and efforts need to be directed toward building a core of intelligible words to facilitate the communication process.