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Guest Blog: Interview with Mary Huston, SLP on Barbara Hodson's Cycles for Phonology Program for Highly Unintelligible Children - featured January 12, 2011

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Guest Blog: Interview with Mary Huston, SLP on Barbara Hodson's Cycles for Phonology Program for Highly Unintelligible Children

By: Tanya Coyle, CCC-SLP and special guest Mary Huston, CCC-SLP
Copyright 2010. Reprinted with the express permission of the author as it appeared on her blog The Lexical Linguist The blog post was originally titled "Sojourn."


I am thrilled to have Mary Huston, Speech-Language Pathologist, as a guest blogger today! She is the resident expert in Cycles for Phonology on Twitter and has been answering so many questions posed to her by other professionals that I invited her to blog about Cycles. Happily for all of us, she accepted. I thought I knew about Cycles and phonology until I met her and realized I don’t know nearly what I thought I did. I hope that her post will enlighten you and help you with Cycles as much as it has helped me. ~Tanya

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Recently I have been asked several questions about Barbara Hodson’s Cycles Program for highly unintelligible children. I’m not quite sure how I became known as the “phono” person, but I will confess to a love of phonology. I also have the benefit of having been trained by someone who has worked closely with Dr. Hodson and will share some of her information as well as Dr. Hodson’s information.

I think the easiest thing to do is to start at the beginning and explain Dr. Hodson’s Cycles program. Cycles was designed to be used with highly unintelligible children and not with children with mild/moderate articulation errors2.

Let’s start at the first of many questions.

What’s the difference between articulation and phonology?
The easiest way to remember the difference between articulation and phonology is articulation is a “handful of errors” where phonology is much broader. It always surprises me to hear clinicians report a “severe articulation disorder” in children. Yes, I suppose it’s possible – but it’s important to look at the types and breadth of the errors to decide if it’s truly articulation or if it’s a sound-system disorder (aka phonological disorder).

Articulation is typically a placement disorder or distortions. The student has formed errors on phoneme placement. Most common of these of course is the /s/ and /r/ errors we have all come to know and dread. It’s important to realize that these are not classes of sounds – but rather certain sounds.

Phonology is a rules disorder1. For whatever reason, the child has not learned the rules of how sounds are made and which sounds can go together. The child will often omit sounds or substitute whole classes of sounds. These errors have a significant impact on a child’s intelligibility.

Where do I start?
The first thing to consider is what errors are present. Dr. Hodson has a wonderful handout that explains the Primary Targets for Cycles therapy (available on the SLP Resource Share). Essentially, start with the first error the child shows that has the most impact on intelligibility. Let me say that again, start with what impacts the ability for the child to be understood first. 2

Omissions are the primary cause for concern and need to be targeted first2. If the child omits syllables – start there. If the child omits initial consonants, but has syllables – start at initial consonants. If the child can produce CV words but not CVC – start with final consonants. If the child has all of those – but can’t produce an /s/ cluster – start there. (Oh, and just to stave off the argument – I mean marking both parts of a cluster, not that the /s/ is distorted)

How do I pick the words I use? Is it really okay to only use 5-6 words?

It’s important to choose the words carefully, particularly for the first couple of cycles2. Assimilation is typically a major problem for clients with severe sound-system disorders so for the first few cycles we want to avoid words with their error sound in them. For instance, if a child is fronting and substitutes a /t/ for /k/ don’t use CAT as a target word. Use a neutral word such as COW or CAR or KING 2,4. The reason for limiting the number of words is two-fold. It gives the client the opportunity to be successful and to practice the words correctly. It also gives the clinician a break because it can be tricky coming up with good words. Keep the child interested by changing the activity. Most important is the client’s success. Cycles therapy is all about the child’s success. In fact, the clinician is supposed to provide enough prompts to have the child be 100% successful at all times and reduce the number of prompts needed as the skills emerge.

How long do I work with each sound?
According to Dr. Hodson, each phoneme or consonant cluster within a pattern is targeted for 60 minutes2. This can be tricky in the school system. What I typically do is work on each sound for 1 week (possibly 2) and then move onto the next sound. When you finish with one cycle meaning you worked all the way through /s/ clusters, /k, g/, and /l, r/ (yes, even /l/ and /r/)2, you “cycle” back through the sounds. Usually about the 3rd time through (2nd for those really quick learners) I start to introduce the carrier phrase of “It’s a ____,” and eventually sentences. When the student has “cycled” through all the target phonemes at least once, Dr. Hodson recommends mixing target phonemes within a pattern so each phoneme is targeted for 2-hours or more2. For instance work on /k/ and /g/ in the same sessions.

When do I work on /f/?
You don’t. Well, actually that’s not true. You do work on /f/ as a secondary target but only after the /s/ clusters are in conversation2, 3. The reason for this is 1) /f/ doesn’t generalize to other fricatives – you can work on /f/ until the cows come home and all you’ll get is /f/, but if you work on /s/ clusters they will generalize to all fricatives; 2) there’s a nasty little coalescence/assimilation1, 2 which can occur with /f/. Many times, kids with sound system disorders that have worked on /f/ will produce /f/ for /s/ clusters and it’s hard to break. Do yourself a favor – save /f/ for later.

When do I work on voicing errors?
Voicing errors are worked on as secondary targets only after /s/ clusters are in conversation and most of the other targets have had success at the word level2, 3. Voicing errors are annoying – and we notice them, but they don’t impact intelligibility nearly as much as the primary targets2.

I think that’s enough for now although I have the feeling I’ll be back later.

Happy Cycling. I look forward to hearing success stories.

Mary Huston, MS, CCC-SLP

Citations
  1. Gordon-Brannan, M., & Weiss, C. (2007). Clinical management of articulator and phonologic disorders – third edition. Philadelphia, PA: Lippincott Williams & Wilkins.
  2. Hodson, B. (2007). Evaluating & enhancing children’s phonological systems: Research & theory to practice. Greenville, SC: Thinking Publications.
  3. Hodson, B. (2010). Potential optimal primary target patterns. Flowchart Handout provided via email. (NOTE: This flowchart is available in the SLPeeps Resource Share folder in Google Docs under Artic/Phono subfolder).
  4. Liddiard Buteau, C., & Hodson, B. (1989). Phonological remediation targets. Austin, TX: Pro-Ed.



Our Featured Guest Blogger: Tayna Coyle and her Guest Mary Huston
Please support our contributors and visit Tanya's blog The Lexical Linguist

About Tanya Coyle: Tanya attended Trent University for her B.Sc in psychology and a minor in anthropology (emphasis on linguistic anthropology). She graduated with a M.Sc. in 2004 from the S-LP program at the University of Western Ontario. She first worked in a local children's treatment centre with children 0-6 years old and learned a great deal about multidisciplinary practice and therapy. She is now a speech-language pathologist working in schools in Southern Ontario. Tanya is co-creator of the SLPeeps Goal Bank and Shared Resource Folder and is also co-moderator of the new #slpchat on Twitter.

About Mary Huston: Mary Huston, MS, CCC-SLP is currently employed in rural North Dakota and works in the school system with children from 3 – 21 years of age. A 2009 Graduate from Minot State University, she was awarded The Citation of Excellence from MSU in 2009; Outstanding Graduate Student-Communication Disorders 2009; Who’s Who Among American Universities and Colleges 2007; and is a Co-Founder of the SLP Resource Share and SLP Resource Goal Bank.

Tags: Newsletter Article Phonological Disorders 14 January 2011