Sariah Folau, SLP

April 11th, 2019

Brigham Young University

Joe’s Intervention Plan

Summary of Client:
Joe is a 10-year-old boy who has previously been diagnosed with a learning
disability. Although he is in the fourth grade, Joe spends part of his day in a special
education resource room where he learns at a pace more suitable to him. Joe has been
evaluated and determined to be reading at a 1st grade level. In addition to his delayed
reading fluency, Joe has difficulty comprehending narratives both in reading and in oral
language tasks as his teacher has said that it is difficult for Joe to follow instructions.
An oral peripheral exam was completed, showing that Joe has no abnormalities in
terms of his speech articulators, including the lips, jaw, teeth, and palate, revealing
adequate structure and function for speech production. A phonetic inventory was also
taken from a language sample drawn from Joe while interacting with a peer, indicating
that he has all phonemes except /r/. Joe’s articulation skills were also assessed using the
Goldman-Fristoe Test of Articulation- 2nd Edition. This portion of the assessment
supported findings from the GFTA-2, however, it found that Joe is stimulable for the
prevocalic /r/ if given a direct model. Testing Joe’s “sounds in sentences” from the
GTFA-2 also revealed that Joe has difficulty with both understanding narratives and
expressing his thoughts in a cohesive way. Interaction with Joe further supports this
claim. Through these and other assessments, it has been determined that Joe qualifies for
speech/language services.

Selected Intervention Approach:

The Traditional Language Approach has been selected for Joe’s intervention
specifically to address his articulation errors with the /r/ phoneme. Because Joe’s
phonetic inventory indicates that Joe is capable of producing all other phonemes besides
/r/, but is stimulable for the /r/ sound when given a model, it is promising that he can
successfully obtain /r/ if continually worked on utilizing the continuum that this approach
offers. However, because Joe also struggles with expressing his thoughts in a cohesive
way, his difficulties being more language associated than articulation, when Joe reaches
step 6 (conversational or spontaneous speech) it is likely that his improvement with the /r/
phoneme will be less apparent. This difficulty may arise not because he can not articulate
it, but because his language abilities make it even more of a hurdle. To assist in his
language acquisition, words, phrases, and sentences will be specifically targeted through
the phases of the intervention that would assist in his generalization to topics regarding
his current environment, books/narratives he is working on, or even scripts that are likely
to be utilized to further address his language impairment.

Goals and Objectives:

Goal #1
 Over the course of the treatment program Joe will produce the phoneme /r/ in
prevocalic positions in spontaneous speech.
 Condition: Joe will produce the phoneme /r/ in the prevocalic
position in conversation with his peers during play.
 Criterion: Joe will have 100% accuracy observed in 3 different
play contexts.
Sariah Folau, SLP
April 11th, 2019
Brigham Young University

o Objective: Joe will be able to produce the phoneme /r/ in prevocalic

positions with mimed imitation of the clinician with 100% accuracy and in
response to pictures at the word level in 2 consecutive sessions.
o Objective: Joe will be able to produce the phoneme /r/ in prevocalic
positions (such as in the words road, recess, or radio) utilizing successive
repetition provided from the clinician with 90% accuracy at the word level
in 3 consecutive sessions.
o Objective: Joe will be able to produce the phoneme /r/ in prevocalic
positions (such as in the words road, recess, or radio) with mimed
imitation of the clinician or in response to pictures in a sentence context
with 90% accuracy in 3 consecutive sessions.
Goal #2
 Over the course of the treatment program Joe will produce the phonemes /r/ in
final vocalic positions at the sentence level.
 Condition: In response to the pictures or delayed imitation of the
clinician
 Criterion: Joe will have 80% accuracy across 3 consecutive
sessions.
o Objective: Joe will be able to produce the phoneme /r/ in final vocalic
positions for /ar/,/or/, /er/, or /ire/ in isolation with simultaneous imitation
of the clinician with 100% accuracy.
o Objective: Joe will be able to produce the phoneme /r/ in final vocalic
positions for /ar/,/or/, /er/, or /ire/ in words such as star, core, mother, or
tire with mimed imitation of the clinician with 100% accuracy and in
response to pictures.
o Objective: Joe will be able to produce the phoneme /r/ in final vocalic
positions for /ar/,/or/, /er/, or /ire/ in words such as star, core, mother, or
tire in response to pictures and metaphonological cueing with 80%
accuracy in 2 consecutive sessions.

Sample Therapy Activity:

Target: Prevocalic /r/ in words such as “recess, reading, writing, running, rocks, radio,
and robot.”

Rationale:
Since Joe is stimulable for the /r/ sound in some pre-vocalic positions, his natural
production of the /r/ phoneme would be noted (whether it is bunched or retroflexed) and
therapy would continue to cater to that production. Furthermore, because Joe is
stimulable for the production of the pre-vocalic /r/, therapy would begin around phase 2
of the traditional based model in which the phoneme is produced in isolation, furthering
to phase 3-nonsense syllables, phase 4-words, phase 5-structured contexts, and finally
phase 6-spontaneous speech.
This therapy activity would focus on phase 4 of the traditional and motor based
approach, assuming that previous therapy sessions have been successful in establishing
Sariah Folau, SLP
April 11th, 2019
Brigham Young University

the pre-vocalic r in isolation and nonsense syllables. This stage will focus on
generalization, assisting in his language acquisition as well.
In foreshadowing of further therapy sessions in which the other phases of the
traditional based approach will be targeted, words have been selected that are common to
Joe’s current environment and will easily generalize into phrases, sentences, and
hopefully to Joe spontaneous speech.

Description:
Joe will be asked to recall previous therapy sessions and a brief review of the /r/
phoneme would be made. Previously made card picturing targeting the words “recess,
reading, writing, running, rocks, radio, and robot,” would be introduced to Joe. The
clinician would show Joe the pictures, saying each word out-loud and asking Joe to
repeat them, emphasizing the selected /r/ phoneme.
After Joe has been familiarized with the words and pictures, the clinician would
go through the cards again asking Joe to name them by himself. If production can not be
obtained, the clinician would ask Joe to repeat the words either immediately following
her production, or at the same time (simultaneous imitation). The clinician may also offer
metaphorical or hand cues utilized in previous sessions to assist Joe. Once Joe is
successful at this level, the cards would be cycled through again, however, cueing would
be withdrawn and mimed or successive repetition would be utilized instead of direct or
simultaneous imitation. When Joe has obtained sufficient success at this stage, the cards
would again be shuffled and Joe would be asked to name the target words without
imitation from the clinician, utilizing only the pictures and the occasional hand cue to
elicit the desired phoneme.
Reinforcement should be made throughout the session encouraging correct
production and attempts made by Joe. When incorrect production arise, the clinician can
provide verbal feedback regarding Joe’s production that may help remind him of how to
obtain a successful production. For example, the cue “use the pirate sound (r).,” or
“remember to pull your tongue back,” would be appropriate feedback tools.
Overall, the objective of this therapy session is to have Joe produce the targeted
words on his own with as little assistance from the clinician as possible, further preparing
him for producing the pre-vocalic /r/ in phrases, sentences, and spontaneous speech.

Sariah Folau, SLP April 11th, 2019

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