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Prosody Treatment Program
Ages: 3-17   Grades: PreK-12

Improving receptive and expressive fundamental prosodic skills means your student will communicate emotions and attitudes, mark the most important parts of his messages, indicate a question or statement, and much more—all without adding additional words. 

Outcomes

  • Develop age appropriate receptive and expressive prosody skills of loudness, pitch, and rhythm
  • Improve overall intelligibility of speech
  • Improve respiration, phonation, and articulation aspects of speech production
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*The CD contains the complete book.  All pages are printable.

Most typically-developing children have mastered the functional aspects of prosodic expression by age five (Wells, Peppe, & Goulandris 2004).  However, students with autism, apraxia of speech, Williams syndrome, dysarthria, and other disorders often present with speech that is monotone, robotic, or overly dramatic.  They may find it hard to understand others' use of prosody. 

Receptive and expressive systematic cues adapted from the dynamic temporal and tactile cueing (DTTC) hierarchy by Strand, Stoeckel and Baas, 2006 are an integral part of this best-practice program.     

Prosody Treatment Program is presented in two sections: Preschool and School Age.  The audio CD contains files that can be used during specific activities and faded as you become familiar with how to model the prosodic patterns.

Section 1: Preschool

This section is appropriate for working with children ages 3-5.  The activities target rhythm, pitch, vocal tone, voice manipulation, melodic patterns, whisper voice, and inflections. 

  • Music activities are natural and fun ways to develop rhythm and pitch.  Students are motivated to produce vocal inflections as they sing.  The simple song melodies use common functional phrases. 
  • The naturalistic and functional strategy of using character voices develops the use of vocal tones.  Preschoolers distinguish story characters by changing tone: deep tones for monsters, squeaky tones for mice, high pitch for babies, etc. 
  • Producing animal sounds develops voice manipulation skills.  Preschoolers listen to and imitate animal sounds in a fun guessing game format.
  • Playing musical instruments develops rhythm and pitch; the concepts slow/fast and quiet/loud, and melodic patterns. 
  • Using expressions develops inflection.  Activities are designed to naturally encourage expressions like wheee!, yum!, ewww!, etc.
  • Additional ideas and clinician tips make it easy to prepare every lesson and maximize progress.  Implementing prosodic treatment early can avoid and/or reduce speech that sounds artificial.

 

Section 2: School Age

This section is appropriate for working with children ages 5-18.  It includes the Prosody Screening Test and activities that provide:

  • instruction and practice for improving prosodic skills in the areas of loudness, pitch, and rhythm
  • quick overviews and directions 

Therapy activities target the skills on the screening test, and include:

  • Loudness—students learn why it's important to control the loudness of their voices based on location, proximity to a conversational partner, and the nature of the conversation.  They also learn how word and syllable stress change and influence meaning of individual words.
  • Pitch—students learn to identify and use high and low pitch to ask a question, make a comment, or give a command.  They learn how pitch gives listeners clues about a speaker's emotion and how changes in their pitch can convey emotion.  Students also learn to interpret and use sarcasm.
  • Rhythm—students learn to recognize and use the rhythmic components of speaking rate and chunking.  These skills are critical to helping listeners understand the meaning of what the speaker is saying.
  • Homework—the activities in this section are designed to help students transfer their prosody skills outside of therapy.

Prosody Screening Test

This test, for students ages 5-18, is designed to give you useful information about your clients to establish baseline data, write treatment goals, and measure progress.  This test examines:

  • Loudness
  • Word Stress
  • Syllable Stress
  • Question Inflection
  • Emotions
  • Chunking
  • Sarcasm   

Copyright © 2013

Components
98-page book with reproducible activities plus audio CD
  • Although aspects of intonation comprehension develop throughout childhood, most functional aspects of prosodic expression are mastered by 5-year-old children (Wells, Peppé, & Goulandris, 2004).
  • Individuals with autism spectrum disorders, apraxia of speech, Williams syndrome, Parkinson's disease, and other diagnoses often have disordered prosody (Odell & Shriberg, 2001; Peppé, 2011).
  • Individuals with autism spectrum disorders often have issues with prosody related to social attunement and social emulation (Shriberg, Paul, Black, & van Santen, 2011).
  • Behavioral interventions addressing prosody are effective across a variety of disorders (Hargrove, Anderson, & Jones, 2009).
  • Dynamic Temporal and Tactile Cueing (DTTC) for Speech Motor Learning (Strand, Stoeckel, & Baas, 2006), Melodic Intonation Therapy (MIT) (Sparks & Holland, 1976), and Lee Silverman Voice Treatment (LSVT) (Ramig, Countryman, Thompson, & Horii, 1995) provide empirically validated treatment strategies for addressing certain aspects of prosody.

Prosody Treatment Program incorporates these principles and is also based on expert professional practice.

References

Hargrove, P., Anderson, A., & Jones, J. (2009). A critical review of interventions targeting prosody. International Journal of Speech-Language Pathology, 11(4), 298–304.

Odell, K.H., & Shriberg, L.D. (2001). Prosody-voice characteristics of children and adults with apraxia of speech. Clinical Linguistics and Phonetics, 15(4), 275–307.

Peppé, S. (2011) Assessment of prosodic ability in atypical populations, with special reference to high-functioning autism. In V. Stojanovik & J. Setter (Eds.), Speech prosody in atypical populations: Assessment and remediation. Guildford, U.K.: J & R Press Ltd.

Ramig, L.O., Countryman, S., Thompson, L.L., & Horii, Y. (1995). Comparison of two forms of intensive speech treatment for Parkinson disease. Journal of Speech and Hearing Research, 38, 1232–1251.

Shriberg, L.D., Paul, R., Black, L.M., & van Santen, J.P. (2011). The hypothesis of apraxia of speech in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 41(4), 405-426. doi: 10.1007/s10803-010-1117-5

Sparks, R.W., & Holland, A.L. (1976). Method: Melodic intonation therapy for aphasia. Journal of Speech and Hearing Disorders, 41, 287–297.

Strand, E.A., Stoeckel, R., & Baas, B. (2006). Treatment of severe childhood apraxia of speech: A treatment efficacy study. Journal of Medical Speech-Language Pathology, 14(4), 297–307.

Wells, B., Peppé, S., & Goulandris, N. (2004). Intonation development from five to thirteen. Journal of Child Language, 31(4), 749–778.

Author(s)

Joseph A. Rothstein

Biography

Joe Rothstein, M.S., CCC-SLP, is a speech-language pathologist in private practice in Santa Monica, CA.  Joe received his bachelor's degree in communicative disorders from West Chester University and his master's degree in speech and hearing sciences from the University of North Carolina at Chapel Hill.  He is a certified member of the American Speech-Language Hearing Association (ASHA) and is licensed by the state of California in speech-language pathology.

Joe is also a musician with specialized training in music education for young children.  He combined his skills as a musician and music educator with his expertise as a speech-language pathologist to create Power Tunes, a children's music CD designed to help toddlers and young children learn vocabulary, speech sounds, and early academic concepts.  The Prosody Treatment Program is Joe's first publication with LinguiSystems.

Introduction

Prosody is often referred to as the rhythm and melody of speech.  Prosody allows us to communicate emotions and attitudes in our utterances, mark the most important parts of messages, indicate a question or statement, and more, all without adding additional words.  Without the appropriate use of prosody, a person's speech may present as monotone, robotic, or overly dramatic.  Some individuals have difficulty understanding others' use of prosody.  As a result, they may not be able to determine from a speaker's voice how the person feels or when the person is being sarcastic.  Like many aspects of speech and language, skill in prosody is often taken for granted.  In fact, this may be truer in the case of prosody than other skill areas because of its subtlety.  Nevertheless, many individuals with speech and language disorders have difficulty with comprehension or production of prosody, or both.  Such populations include individuals with autism spectrum disorder (ASD), apraxia of speech, Williams syndrome, Parkinson's disease, and other disorders (Odell & Shriberg, 2001; Peppé, 2011).

Researchers studying the development of prosodic skills indicate that although aspects of intonation comprehension develop throughout childhood, 5-year-old children have largely mastered most functional aspects of prosodic expression (Wells, Peppé, & Goulandris, 2004).  There's great variability in how and when individuals acquire prosodic skills; however, it's clear that many individuals with disorders, such as ASD and apraxia of speech, don't fully develop prosodic skills on their own (Odell & Shriberg, 2001; Peppé, 2011).  As with treating any aspect of speech and language, early intervention is greatly beneficial to individuals who have difficulty with prosody.  A systematic review of the literature in prosody interventions (Hargrove, Anderson, & Jones, 2009) indicates that although there's a shortage of empirical research into the efficacy of treatments targeting prosody, the existing evidence clearly shows that behavioral interventions are effective across a variety of disorders.

Methods for treating deficiencies in various prosodic skills are described in the literature.  Additionally, there are some familiar protocols that use techniques to develop prosodic skills.  These include Dynamic Temporal and Tactile Cueing (DTTC) for Speech Motor Learning (Strand, Stoeckel, & Bass, 2006), Melodic Intonation Therapy (MIT) (Sparks & Holland, 1976), and Lee Silverman Voice Treatment (LSVT) (Ramig, Countryman, Thompson, & Horii, 1995), among others.  However, there's currently no single comprehensive resource for treating both receptive and expressive prosodic skills.  I've attempted to fill this gap with the Prosody Treatment Program by providing exercises to train clients in fundamental prosodic skills, both receptively and expressively.

 

Note About Using the Audio CD
The audio CD included with this program contains audio files that you can use with the client to present specific activities.  However, once you're familiar with how to model the targeted prosodic patterns, consider producing the stimuli yourself for the client.  This way, the client can benefit from hearing the natural variability that occurs in spontaneous speech.

Joe