Major focus area

Speech Therapy -> Phonology

Short description

In paired-stimuli approach (PSA) the SLP builds on speech sound productions that are already in the patient's repertoire to teach the production of those sounds in other contexts. The highly structured technique practices these sounds in a variety of phonetic contexts (Irwin & Weston, 1975).

Long description

Paired Stimulation Approach (PSA) is based on principles of operant reinforcement contingencies and depends on identifying a key word in which a target sound appears once, in either initial or final position, and is produced correctly 9/10 times. Key words are used to teach the production of sounds in other contexts. Pictures are used to evoke the target words. A single speech sound is targeted at any one time, as opposed to approaches that target multiple speech sounds simultaneously.

Method:
1) Select target sound for instruction (e.g., /r/)
2) Find/create 4 key words (rock, run, red, rain).
3) Select 10 training words in which target sound is misarticulated and the sound appears only once in the same position as the key word.
4) Select pictures as stimuli to evoke the word productions
5) Put the first key word in initial position in the center and arrange the 10 training words (pictures) around it; this is known as a training string.
6) Instruct the patient to say the key word, name one of the target words, and say the key again (ring-rock-ring)
7) Patient names another target word; alternate the key word and all training words in this manner.
8) Include 3 training strings in each session
9) Reinforce correct productions and adhere to a training criterion of 8-10 correct productions of the training words in 2 successive training strings without reinforcement.

Note: Word level training would be followed by training at the sentence and conversational levels. PSA is effective because it usually builds on behaviors already in the patient's repertoire, takes little time to teach, and practices sound in a variety of phonetic contexts (Irwin & Weston, 1975).