Establishing a Basic Speech Repertoire without Using NSOME: Means, Motive, and Opportunity

ABSTRACT

Children who are performing at a prelinguistic level of vocal communication present unique issues related to successful intervention relative to the general population of children with speech disorders. These children do not consistently use meaning-based vocalizations to communicate with those around them. General goals for this group of children include stimulating more mature vocalization types and connecting these vocalizations to meanings that can be used to communicate consistently with persons in their environment. We propose a means, motive, and opportunity conceptual framework for assessing and intervening with these children. This framework is centered on stimulation of meaningful vocalizations for functional communication. It is based on a broad body of literature describing the nature of early language development. In contrast, nonspeech oral motor exercise (NSOME) protocols require decontextualized practice of repetitive nonspeech movements that are not related to functional communication with respect to means, motive, or opportunity for communicating. Successful intervention with NSOME activities requires adoption of the concept that the child, operating at a prelinguistic communication level, will generalize from repetitive nonspeech movements that are not intended to communicate with anyone to speech-based movements that will be intelligible enough to allow responsiveness to the child's wants and needs from people in the environment. No evidence from the research literature on the course of speech and language acquisition suggests that this conceptualization is valid.

Prelinguistic development - vocalization - language development - NSOMEs - intervention - generalization

REFERENCES

• 1 Marshalla P. Oral Motor Treatment” vs. Non-Speech Oral Motor Exercises. Mill Creek, WA; Oral Motor Institute 2008
• 2 Rosenfeld-Johnson S. Talk Tools. Tucson, AZ; Interactive Therapists International http://www.talktools.net Accessed June 12, 2008
• 3 Marshalla P. The role of reflexes in oral-motor learning: techniques for improved articulation.  Semin Speech Lang. 1985;  6(4) 317-336
• 4 Bahr D. Oral Motor Assessment and Treatment: Ages and Stages. Boston, MA; Allyn & Bacon 2001
• 5 Lof G. Reasons why non-speech oral motor exercises should not be used for speech sound disorders. Paper presented at: annual meeting of the American Speech Language and Hearing Association 2007 Boston, MA;
• 6 Bahr D. Coordinated Oral Motor Treatment: From No Speech to Speech. Advances for Speech-Language Pathologists and Audiologists. Boston, MA; Allyn & Bacon 2001
• 7 Wetherby A M, Prizant B. Communication and Symbolic Behavior Scales. Chicago, IL; Riverside 1993
• 8 Girolametto L, Pearce P, Weitzman E. Effects of lexical intervention on the phonology of late talkers.  J Speech Lang Hear Res. 1997;  40 338-348
• 9 Bondy A S, Frost L A. The Picture Exchange Communication System.  Behav Modif. 2001;  25(5) 725-744
• 10 Yoder P, Warren S F. Maternal responsivity predicts the prelinguistic communication intervention that facilitates generalized intentional communication.  J Speech Lang Hear Res. 1998;  41 1207-1219
• 11 MacDonald J D, Carroll J Y. A social partnership model for assessing early communication development: an intervention model for preconversational children.  Lang Speech Hear Serv Sch. 1992;  23 113-124
• 12 Durand M V. Functional communication training using assistive devices: effects on challenging behavior and affect.  Augment Altern Commun. 1993;  9(3) 168-176
• 13 Brady N C, Steeples T, Fleming K. Effects of prelinguistic communication levels on initiation and repair of communication in children with disabilities.  J Speech Lang Hear Res. 2005;  48 1098-1113
• 14 Yoder P, Stone W L. A randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD.  J Speech Lang Hear Res. 2006;  49 698-711
• 15 Norris J A, Hoffman P R. Comparison of adult-initiated vs. child-initiated interaction styles with handicapped prelanguage children.  Lang Speech Hear Serv Sch. 1990;  21 28-36
• 16 Girolametto L, Weitzman E, Clements-Baartman J. Vocabulary intervention for children with Down syndrome: parent training using focused stimulation.  Infant-Toddler Intervention. 1998;  8(2) 109-126
• 17 Millar D C, Light J C, Schlosser R W. The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review.  J Speech Lang Hear Res. 2006;  49 248-264
• 18 Forrest K. Are oral-motor exercises useful in the treatment of phonological/articulatory disorders?.  Semin Speech Lang. 2002;  23(1) 15-26
• 19 Forrest K, Iuzunni J. A comparison of oral-motor and production training for children with speech sound disorders.  Semin Speech Lang. 2008;  ▪▪▪ 29
• 20 Davis B L, Velleman S L. Differential diagnosis and treatment of developmental apraxia of speech in infants and toddlers.  Infant-Toddler Intervent. 2000;  10(3) 177-192
• 21 Strand E A. Treatment of motor speech disorders in children.  Semin Speech Lang. 1995;  16(2) 126-139
• 22 Maas E, Robin D A, Austernann-Hula S N, Freedman S E, Wulf G. Principles of motor learning in treatment of motor speech disorders.  Am J Speech Lang Pathol. 2008;  17 277-298
• 23 McCune L, Vihman M M, Roug-Hellichius L, Delery D B, Gogate L. Grunt communication in human infants (Homo sapiens).  J Comp Psychol. 1996;  110(1) 27-37
• 24 Dollaghan C. Handbook for Evidence Based Practice in Communication Disorders. Baltimore, MD; Paul H Brookes 2007