Introducing: Using Hodson's Cycles Approach for Phonological Process Remediation
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you are taking me back to grad school :)
ReplyDeleteKristin, I know it! I kind of felt that way when I was writing it. Ha! But...it's a good refresher I think. At least it was for me. :)
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DeleteThanks for the post - one of my favorite treatment approaches!
ReplyDeleteThanks Kathy! I do love using cycles bc of how quickly I can see improvement in overall intelligibility over a few weeks. Then its just fine tuning. Ha! Thanks for ur comment
DeleteI am trying my hand at Cycles this year for some of my highly unintelligible/phonological children. I understand that there are only 4-6 target or practice words per session but are those the only words you practice? So if I'm working on /sm/ and my words are smoke, smile, small, smell, do we practice any other /sm/ words during the session or just do lots of repetitions of those four words? I feel like practicing lots of other words is basically just drill work but sticking with just the four target words gets boring. Any suggestions? Thanks so much for all the wonderful information!
ReplyDeleteThe quick answer to your questions is YES you only practice the specifically chosen target words (Hodson recommends 5-6 words).
DeleteHere's the longer answer:
Always start with auditory bombardment. Then practice target words. With those target words, Hodson recommends that we spend 60 minutes on EACH phoneme and change activities every 7-8 mins (I always make 2 copies of target words...so maybe you do a memory/concentration game first, followed by hide n seek with the cards, followed by cards on twister mat, followed by guessing game...you describe each word child guesses, followed by "go fish"...if you spend 8 mins each activity, that 40 mins of a 60 min therapy session right there), after this practice you also need to do an extension activity (Hodson calls them metaphonological activity...fancy way of saying phonological awareness activity) so maybe you practice rhyming words with these targets, or blending the target words together, or you segment the words, or you ID initial, medial, or final sounds of each word...any activity that makes the child more aware of the phonological make up (so to speak) of the word. You follow this by probing for sound to target the next session (so do you have to actually teach placement of sounds or practice oral motor movements of sounds child cannot yet make...this would be the time to practice that). Follow this by auditory bombardment again and send pics home for homework! I also send auditory bombardment lists home for parents to read 2xs day (1x morning and 1x night)...I LOVE Webber's jumbo artic book for those word lists...I just print and parents change up which list of 20 words they want to read each time. I find that if I just send home the lists and the 5 or 6 target words I get MUCH more compliance and carryover at home b/c it should only take a few mins a day (Hodson suggests 2 mins/day)
What if I don't have 60 mins all at once? Well I used this technique in the school setting all the time and I just focused on the same phoneme for 2, 30 min sessions a week or 3, 20 min sessions. This way we targeted the the phonological process for 60 mins in a way that was doable in the school setting. I will say that the research wasn't standardized using these modifications so they may or may not have an effect on rate of progress but I personally have never noticed any difficulty with progress using this technique even if I modified it. And as the newest research is showing improvement for shorter more frequent therapy sessions, these modifications may actually be the way to go. Who knows? I'm just telling you this so you understand that (at least in my experience)...Hodson's cycles is the best intervention for phonological processes even if I had to modify it a bit.
Word of Caution: make sure that the children you are using this technique with do have phonological processing issues and not just articulation issues. Simple ? I ask myself...is this omission, distortion, substitution systematic? If so its a phonological process, if not...its articulation. So for your kiddo...does the child reduce or substitute ALL blends...if so than you should be using this approach!
Ok that was a ton of info. I hope this helped. If you have any more ?s feel free to comment or you can just email me directly.
Thanks
That is very helpful--thank you!! One more question...I work in a school and have lots of kiddos on my caseload, therefore, I group most of them. When it comes to doing Cycles, will it work in groups if they're working on the same sounds/patterns?
DeleteI do not know of any research information regarding doing this approach in groups, so I don't know that I can effectively answer that question. If anyone out there reading this knows of any, we would greatly appreciate if you could direct us too that research.
DeleteI also never had enough true phonological processing kiddos on my caseload to warrant group therapy so I don't think I have ever even thought about it let alone attempted it. However, this is a nice PPT on asha.org that reviews what we do know about the research for children with articulation disorders. http://www.asha.org/Events/convention/handouts/2008/1851_Baker_Elise_2/
There are two things that I come away with as really important in this PPT (although there are LOTS of good things). A growing body of evidence suggests that effective treatment for speech and sound disorders included:
1. Use of maximal contrasts and use of complext targets (vs. the developmental model which has been drilled in our heads as school SLPs...so actually targeting later developing sounds 1st will result in improvement for both later and earlier developing sounds)
2. AND teaching of metaphonological skills/phonological awarenss skills
OF COURSE YOU DO THESE THINGS ALTERNATELY NOT SIMULTANEOUSLY WITHIN A SESSION.
I will say that most of the evidence gathered over the years suggests the most effective treatment environments are 1:1 for 30-60 mins., according to this info.
BUT does it mean all children need to be 1:1. Of course not! There is also a growing body of evidence for very effective management and improvement of articulation disorders via the use of 5 minute blast therapy (also knows as 5 mins artic sessions).
I think it really comes down to the what works for each individual child!
So to attempt to answer your ?. I probably would stay away from attempting the cycles approach in groups just b/c we don't know if it is effective. As this is your first attempt with cycles, maybe (and this is just a suggestions) you could use this approach for just a few of your severely unintelligible phonological processing kiddos (so you choose 2 or 3 kiddos you can devote 1:1 to...I KNOW this may be a REAL struggle and may not even work...maybe all you can get is 1 student, depending on your caseload), and attempt to use other phonological treatment approaches (see more in that PPT above)in group therapy sessions or 5 min blast artic therapy for your artic kiddos.
Great ? I really appreciate you asking it!
Good luck!
Oh my goodness how could I forget this PPT on asha.org as well! http://www.asha.org/Events/convention/handouts/2010/SC20-Williams-Lynn/
DeleteIt a really nice PPT eplaining 18 different phonological treatment approaches for speech sound disorder from Asha convention in 2010!
This is a really nice handout for us all!!
Thank you so much for all of the wonderful information!!!
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