PACT

PACT
Parent and Children Together

  • Population:
    • Ages: 3-6 years old 
    • Possible populations (no research on outcomes)
      • Language Impairment/SLI
      • Pragmatic difficulty
      • Cognitive Impairments
      • Cochlear Implants 
      • CleftPalate
      • SSD
      • ASD
      • Down Syndrome
      • FragileX
      • Williams Syndrome 
      • Bilingual homes
      • CAS- childhood apraxia of speech
  • Goals and Targets of PACT:
    • Three goals:
    1. basic intervention goals
    2. Intermediate intervention goals
    3. Specific intervention goals 
    • Broad Goal: increase presence and responsibility on the role of the parent to assist with carrying out the intervention
    • Selection of targets should be flexible and should response to the kids needs
    • Targets:
      • Developmental sequence
      • Stimulable phonemes for which the child has the most knowledge for minimal contrasts
      •  Inconsistent errors
      • Deviations that are most destructive to intelligibility (e.g., stopping of fricatives)
      • Most deviant from the norm
      • Socially or personally important to the particular child 
  • Three Founding Principles:
    1. Modification of groups of sounds produced in error in a patterned way
    2. Emphasis on establishing feature contrasts rather than accurate sound productions
    3. Making it explicit to the child that the function on phonology is communication, specifically by working at the word level in naturalistic parent-child communicative contexts 
  • 5 Main Components:
  1. Parent Education
    • Well informed parent is a therapeutic resource
    • Parent involvement enables fewer clinical consultations and contact hours by the SLP
    • Parents as therapists 
  2. Metalinguistic Training
    • 3 phonological Levels:
    1. Underlying expectations
    2. Surface Form
    3. Mapping rules or connections between the underlying and surface
    • Parents use that "fixed-up-one-routine" and praise in the home setting
  3. Phonetic Production Training
    • Stimulability techniques therapist teaches the child how to make the sounds they are having difficulty with
    • Parents work with the child at home with listening and talking games and activities
    • MOVES to Phonemic level once stimulable 
      • activities are communication and meaning based
      • No more than 6 targets at a time'
  4.  Multiple Exemplar Training
    • Parent and therapist read words lists to the child
    •   Child learns to sort words according to their sound properties 
  5. Homework
    • Activities from the most recent session for 5 to 7 minutes one, two or three times a day
    • Practice sessions can be as little as 10 minutes apart
    • Should be regular, brief, naturalistic and fun
  • Session Outline:
  1. Rhyming auditory brimbarment
  2. Auditory bombardment rhyming close task 
  3. Minimal contrast task
  4. Judgment of correctness task
  5. Fixed-up-one routine
  6. Listening to an audio recording
  7. Auditory bombardment (AGAIN)
  8. Homework explained, modeled and rehearsed









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