Ong Sock Yee (Group B)

Case Study 1: Annie

i) About the intervention
ii) Effectiveness

Promoting Awareness of Sounds in Speech (PASS) program is a comprehensive phonological awareness early intervention curriculum designed for preschool children with speech and language impairments. The PASS program was implemented with 11 preschool children with speech and/or language impairments. It focuses on the sound structure of spoken language. It consists of detailed lessons, specific learning objectives ordered in a developmentally appropriate sequence, rhyming, sound blending and sound segmentation (Roth, Troia, Worthington, & Handy, 2006).

Moreover, the classroom curriculum also incorporates Orton–Gillingham-Stillman (1992) multi-sensory approach for teaching alphabetic principal (as cited in Roth, et al, 2006). A variety of play-based and learning activities including music and the arts serves as mechanism for establishing grapheme-phoneme association that helps supports the PASS program.

This is supported by Gilliam & Mcfadden 1988 that children 4 to 8 had shown reliably significant progress on phonemic awareness tasks after being exposed to other phonological awareness interventions. It includes, judging initial sound, sameness, identifying initial and final phonemes (as cited in Roth, et al, 2006).

After the PASS intervention program, the 11 preschool children demonstrated substantial improvement in their awareness of sounds in speech for example, improved blending ability.

(iii) How will the child benefit from this intervention?

(In assumption that Annie’s facial deformity is due to Cleft lip and Palate)

Annie’s difficulties in speech, emotional, social and behavioural issues are common traits seen in other children with Cleft Lip and Palate (Shah & Wong, 1980). One of the main reason, that constitutes to Annie’s social, emotional and behavioural difficulties is due to difficulty expressing herself in speech.

I feel that Annie would benefit from the PASS intervention as speech delays is one of the main issue due to cleft lip and palate. Hypernasal speech is the most common speech defect in children with Cleft Lip and Palate (Shah & Wong, 1980). Hence by understanding how PASS works we can take into consideration the phonological shape and phonetic composition of words to be taught.

This allow us to teach Annie words that is within the range of her consonant inventory before expanding her vocabulary with words with new sounds. Words with simple syllable structure that include nasals are (e.g., CV, CVC, and CVCV). This is important as we want to build on the child’s strength and to gradually build on her confidence in pronouncing and using words she is comfortable with. I believe that the PASS intervention program would contribute in helping Annie to develop good speech habits. This would allow Annie to enhance her ability in expressing herself that would help her to cope with her emotions and to relate better to her peers.

Moreover, by using a multi-sensory approach to reinforce alphabetical principal through a variety of mediums Annie would get to learn holistically. It also encourages Annie to express her thoughts, feelings and ideas more freely using other mediums instead of just through verbalization.



(iv) your suggestions to cater to the needs of the child

Collaboration with Paraprofessionals

To better cater to Annie’s needs I would engage with Annie’s multi-disciplinary team that focuses on early intervention and treatments for her. This would include hearing, speech, dental, medical, psychological, surgical paraprofessionals and Annie’s family members.
This is crucial as the paraprofessionals consistently share information about Annie’s condition which enables us to have a more holistic picture and how it can be further improved. One example is that if we are informed that Annie has ear infections commonly seen in children with Cleft Lip and Palate it allows me to re-adjust the classroom environment to suit her needs. I would do so by sitting Annie nearer to me, reduce noise level in class using carpets and also to use visual cue cards.

In another example, I would consult with Annie’s dentist to see whether Annie’s biting is due to oral discomfort. If so what are the methods I can use to help reduce Annie’s oral discomfort. By doing so it allows me to tackle the root cause of the problem instead of merely treating the symptoms. To help the family better cope with Annie’s condition is through communicating with them regular and helping to see that Annie is as capable as any other child. If needed I would refer Annie’s parents to other useful resources.

Improving Annie’s Emotional and Social Behaviours

To promote Annie’s self-concept and self-acceptance, I would point out the positive attributes in others that do not only involve physical appearance. Furthermore, I would focus on Annie as an individual with her own strengths, interests and abilities instead on her cleft. I would also model appropriate ways of expressing various emotions through labeling the different feelings. Moreover, I would adjustment the classroom environment by including soft elements in the learning centers, for example at the library corner they would be place for individual area where any child could retreat in. In the art corner I would include easy access to dough for Annie and other children to pound on, in the literacy corner I would encourage Annie and other children to write or draw in their personal journal as a form of emotional outlet.

Improving Annie’s Speech and Communication

One of the ways, for Annie forge greater communication among Annie and her peers is through introducing buddy systems. I would also provide ample opportunities for Annie to participate in class both verbally and non-verbally through different modes of communication, for instance, sign language and creative drama. It is also crucial to provide Annie time to express herself and not to interrupt or fill in gaps for her and reminding the rest of the children to do so. I would also role model good speech patterns. By keeping up-to-date on Annie’s accomplishments in her speech therapy it allows me to reinforce the desirable behaviour through positive reinforcements.

Reference:

Roth, F. P., Troia, G. A., Worthington, C. K., & Handy, D. (2006) Promoting awareness of sounds in speech (PASS): The effects of intervention and stimulus characteristics on the blending performance of preschool children with communication impairments, pp. 67-88. Retrieved on September, 2, 2009, from JSTOR database.

Shah, P, C. & Wong, D. (1980). Management of children with cleft lip and palate, pp. 19–24. Retrieved on September, 2, 2009, from PubMed Central database.

Ong Sock Yee (group B)