Choosing Appropriate Target Words While Using Hodson’s Cycles Approach
HOW IT WORKS
Listen, take a quiz, and earn a certificate of completion! Listen to this episode course at the bottom of this page or on your favorite podcast listing platform (Spotify, Apple Music, etc.). ASHA requires that CE courses take attendance (your unique login) and learner earns a certificate of completion (by passing the quick quiz). This program has been approved for 1 clock hour of continuing education credit by the Texas Speech-Language-Hearing Association (TSHA). TSHA approval does not imply endorsement of course content, specific products, or clinical procedures.
TSHA continuing education (CE) hours can be used toward renewal of your Texas license (and most other states too) and as professional development activities for the maintenance of your ASHA Certificate of Clinical Competence (CCC).
The Pep Talk Podcast for SLPs podcast episode courses have been planned and implemented in accordance with the policies of the Continuing Education Board of the American Speech-Language-Hearing Association (ASHA). TSHA is accredited by the ASHA CEB to provide continuing education for speech-language pathologists and audiologists.
DESCRIPTION AND LEARNING OUTCOMES
This course reviews Hodson’s Cycle Approach. It explains who it is for, how to implement it, and how to choose and use appropriate target words for your therapy sessions. 1 clock hour of continuing education credit (Introductory Level, Professional Area).
As a result of this presentation the participant will be able to:
1.Learner will be able to identify who the cycles approach is appropriate for.
2. Learner will be able to make a list of the primary patterns of the cycles approach.
3. Learner will be able to identify characteristics of appropriate target words for a specific primary pattern in the cycles approach.
4. Learner will be able to tell how to use chosen target words with the cycles approach in a therapy session.
ABOUT THIS EPISODE’S SPEAKERS
Michelle Andrews M.S. CCC-SLP
Founder and Managing Director
Michelle has been a speech-language pathologist since 2014. She has worked in the schools, private clinics, and home health. She started creating speech therapy materials for SLPs years ago and founded Pep Talk LLC. She discovered her passion for education and developed this continuing education podcast for SLPs everywhere. She desires to help SLPs feel confident and to produce the best treatment by increasing knowledge and skills.
Suzanne Aldrich M.S. CCC-SLP
Suzanne has been a licensees SLP for over a decade. She has a bachelor’s degree in special education and a master’s degree in speech language pathology. Suzanne specializes in articulation disorders, phonological disorders, and childhood apraxia of speech. She is passionate about keeping up with current research and trainings. Learn more about Suzanne here.
Michelle Andrews’ financial disclosers include: She has a Teachers pay Teachers, Boom Learning, and Teach with Medley store under Pep Talk LLC. She is also the founder and manager of Pep Talk and the Pep Talk Podcast. Teach with Medley Educational Games is a sponsor of this podcast.
Michelle Andrews’ non-financial disclosures include: She has a stock participation plan with Teach with Medley Educational Games.
Suzanne Aldrich’s financial disclosers include: Suzanne has a Teachers pay teachers store called, PlayingSpeech, where she sells materials related to treating speech and language disorders.
Suzanne Aldrich’s non-financial disclosers include: No relevant non financial disclosers.
5 min: Introduction, bio, disclosures, learner objectives
15 min: Review on Cycles Approach
15 min: choosing targets words
15 min: what will a therapy session look like
10 min: summary, ”take away” points, closing
Click to expand this episode's transcript.
Michelle Andrews: Hey everyone. I’m Michelle Andrews. And I’m your host for the pep talk podcast. Where today we are learning all about choosing target words while using Hodson’s cycles approach with my guest speaker, Suzanne Aldrich. Suzanne has extensive experience using and teaching about the cycles approach. I can’t wait for you to learn all about what she has to teach us. This is the first episode of the pep talk podcast. So let me tell you a little bit about myself. I’ve been a speech language pathologist for almost eight years. Now. I have worked in the pediatric population in the schools, private clinic and home health. I have focused on speech sound disorders and early language delays, but enjoy the whole spectrum of speech pathology, I graduated with my master’s degree from Texas women’s university and 2014 and that same month I married my college sweetheart, and we have three wonderful children. I love learning. I love school. So I’m here to continue learning and to help you do the same
Before we get into our topic. [00:03:00] I need to go over some financial disclosures. My financial disclosures include, I have a teachers pay teachers, boom learning, and teach with medley store all under a pep talk, LLC where I make and sell speech therapy materials. Also, this podcast is sponsored by teach with medley educational games. I am also the founder and manager of pep-talk and the pep talk podcast. My non-financial disclosures include. I have a stock participation plan with teach with medley, our sponsor for this podcast. Thank you to our sponsor. Teach with medley educational games. This podcast is made possible because of your sponsorship.
Now I will go over the learner objectives for this. Number one, you will be able to identify who the cycle’s approach is appropriate. For number two, you will be able to make a list of the primary patterns of the cycles. Approach. Number three, you will be able to identify characteristics of appropriate target words for a specific primary pattern in the cycles approach. Number four, you will be [00:04:00] able to tell how to use target words with the cycles approach in a therapy session.
Now. Let’s get started.
Michelle Andrews: Okay here we go. This is the first episode of the pep talk podcast. I am very excited to have Suzanne Aldrich with me today. Hi Suzanne!
Suzanne Aldrich: Hi Michelle
Michelle Andrews: Hi, Suzanne is going to walk us through choosing appropriate target words While using Hodson’s cycles approach Suzanne has been a licensed SLP for over a decade. She has a bachelor’s degree in special education and a master’s degree in speech language pathology Suzanne specializes in articulation disorders phonological disorders and childhood apraxia of speech. She is passionate about keeping up with current research and trainings, I see her on social media posting about the latest article she’s reading- that is very important to her. Suzanne and I share an uncommon personal life situation. We both had three kids and three years so we’re the crazy ones [00:05:00] out there doing that. So with our youngest currently being two. So we’re in the thick of it right now, but still wanting to learn all we can. Suzanne Aldrich’s financial disclosures include Suzanne has a teacher’s pay teachers store. Called playing speech, where she sells materials related to treating speech and language disorders. Her non-financial disclosures include no relevant. Non-financial disclosures. All right, Suzanne, tell me a little bit more about yourself.
Suzanne Aldrich: Okay, so I’ll give you a little bit of the speech first and then a couple personal tidbits. Um, I started my career in the me SLP world. and I worked for two of the top rehabs in the country one here in New Jersey and one in Texas but when we moved back to New Jersey I was I had to get out of the healthcare world you know the burnout So I moved to middle. Um which was fascinating I loved it and I loved all the language but then I had started having babies. So I, [00:06:00] you know, retired, resigned from the middle school. Um, and I started seeing clients privately, in their homes, all the while still doing early intervention So I’ve kind of run the gamut of speech therapy from birth to geriatric but currently right now, you know, it’s just solely my private practice, where I focus on speech sound disorders and early language, you know, zero to preschool ish, um, age. And then if you wanna know anything about me personally, I mean, I don’t have a time for a lot of hobbies with the three kids, um, ages five four and two Um, so when I’m not you know chasing them around I’m reading all of the things, , for fun or research and um that’s pretty much it that’s really all. I have time for.
Michelle Andrews: Yeah That’s great That’s great So tell me a little bit about how you accumulated all of your knowledge and experience with the cycle’s approach.
Suzanne Aldrich: Yeah Well so to be honest, I don’t remember exactly how I came across this approach but I [00:07:00] know I didn’t learn it in grad school And, um You know, I think I just started going down the rabbit hole of journal articles and, and I think I even listened to a podcast, bought some textbooks online. I started to try to teach myself and I realized not everything was in one place and there was all of this different information. So I just had to. I just had to build it myself from different sources. , and then what I found really helpful was anytime I could find a webinar that was done by Barbara Hodson herself I signed up it didn’t matter what it cost. I was like, I’m gonna, I’m gonna pay anything to hear her. Um so that was it. And then I just jumped right in and started implementing the approach and learning you know learning through experience I guess you could Let me tell you my cycles story. Let me tell you my first cycle’s client. And now that I’m thinking about it, this is my, this is my cycle’s origin story and why I started to research this approach because I was like I have this very highly unintelligible just turned [00:08:00] three-year-old and her mom is a speech therapist. What am I gonna do? so I think that’s how I started going down the rabbit hole I was looking up you know phonological interventions for preschoolers, and I mean this was you know a few years ago uh and I came upon the cycle’s approach. And so she, I mean, she was highly unintelligible this child, she had a ton of patterns and like I said, mom was an SLP and I know we got through. Two to three cycles and the intelligibility just took off like the, the child’s own mother couldn’t understand her, who was an SLP. And by the end of our third cycle everyone was understanding her and we moved on to then we went to minimal pairs and then finally all that was left for this child was that vocalic R she even had initial R and R blends and I credit that to working on it So early on in cycles so she you know she had all those pre vocalic R and and those R blends And then just [00:09:00] left left off with just a vocalic R So she you know she’s like I I call her my like uh Magnum Opus because we, we went through every phonological, like, took her from completely unintelligible to intelligible. And we went through like cycles, minimal pairs, Arctic approach by the end. And um you know so that was that’s the Testament to the the beauty of cycles the magic of cycle
Michelle Andrews: that’s Awesome And wow Yeah Suzanne I, whenever you see that progress in a client that you’re working with that’s why we do what we do I mean that’s seriously the coolest thing to see and to see the parents be so happy and it’s life changing. It really, really is. And to see how, how the cycles approach work so well,
Suzanne Aldrich: I have to say, you know, mom being an SLP was a help too, because if I did, I did send home words for her, um, to practice. And I know mom did them faithfully every week. And you could just see the progress in that. Child, because of all the, you know, [00:10:00] the home practice too. I don’t say that to make people feel bad. Like, oh, I can’t get my families to practice at home, but just when you see that carryover at home, it just, it just makes the growth exponential.
Michelle Andrews: Yes. Yes. And you can tell sometimes too, like I know you’re working at home, this is so amazing. Thank you. And it’s, it’s working so well. That’s awesome that you have a story like that, that just really catapulted you to wanting to learn more about the cycle’s approach and become an expert in it.
Suzanne Aldrich: Yeah, I it’s funny. because like when you asked what made me start to learn about the cycles first, I was like, I don’t remember. But then I was thinking of the story and I was like, this is why she was why. And um, yeah. So I’m glad, I’m glad that I did that.
Michelle Andrews: that’s awesome. Yeah, that is extremely helpful. I know I’ve struggled to feel confident with the cycle’s approach. I’m really looking forward to hearing all of what you’re about to teach us. Let’s first. Make sure we all understand exactly what the cycle’s approach is. I know I learned about it in grad school a little bit, [00:11:00] but it’s been a while and I want us all to feel very confident in how, how to use the cycle’s approach correctly. Suzanne, what is the cycles approach?
Suzanne: Okay. So in a nutshell, um, it’s a phonological intervention. So it’s something that you’re gonna use to treat a child with a phonological disorder, not a child with an articulation disorder, not a child with CAS. however, , you will see sometimes those children who have both a phonological order and a CAS, and you may use cycles with that type of child, but I wanna stress that it is. Phonological intervention for phonological disorder. and then I think this is the big one, uh, that a lot of people don’t understand about the cycle’s approach, that the overarching goal of cycles is to improve overall intelligibility. It’s not to master specific sounds so I think that’s a hard one for people to grasp and wrap their heads around And then you know, what it’s, what the cycles approach is meant to do is mimic. The gradual phonological development that you see in [00:12:00] natural speech acquisition So, you know, that cycles in a nutshell.
Michelle Andrews: Cycles in a nutshell. Thank you for that. Uh, phonological intervention to increase intelligibility. All right. So who is the cycle’s approach appropriate for then?
Suzanne Aldrich: So, like I said, it’s gonna be a child with a phonological disorder They’re highly unintelligible um extensive omissions and substitutions So not you know not the child who um has a couple of phonological errors. This is gonna be a child with you know extensive phonological errors, limited consonant repertoires. And it can be used with really young children and also even you know children who are cognitively delayed or um have other diagnoses.
Michelle Andrews: Yes. I was reading about the importance of early intervention for toddlers, once the child is 5 years old, if they are unintelligible, it can impact their literacy acquisition. So using the cycles approach, if its appropriate for those 2 year olds, 3 year olds, 4 year olds, that are[00:13:00] highly unintelligible, it can really be beneficial before they enter kindergarten.
Suzanne Aldrich: As soon as I can, I’m bringing out graphing cards to link them with the speech sound we’re always incorporating those metaphor, illogical activities too, because of that, that literacy piece.
Michelle Andrews: Intelligibility over phoneme acquisition can be a more meaningful measure for intelligibility. Having a significant delayed intelligibility can really affect their literacy acquisition when they go to school. Configuring their intelligibility can be- collecting a spontaneous speech sample of at least a hundred words and have an unfamiliar listener, write a dash. If they don’t understand the word or a check, if they do understand the word and you can tally ’em up and see what percentage the child is understood. This is great, Suzanne. Uh, next I would like you to tell me. Exactly what a cycle is, then
Suzanne Aldrich: Okay, so this is the big, this is the big piece, right? What is a [00:14:00] cycle? It’s the period of time. It takes for you to facilitate every phonological pattern in the primary patterns and every phoneme within those patterns, each one for 60 minutes. So a cycle would be all your primary patterns and all the phone names within those pattern. That’s one cycle. Um, the length of each cycle depends on how many primary patterns you’re gonna target and how many phonemes within those patterns you’re gonna target. So the length of each cycle will vary. So yeah, once you’ve addressed all of those primary patterns and all the phonemes, then you’ve completed one full cycle.
Michelle Andrews: Okay. So it’s gonna vary from client to client, depending on how many primary patterns and, and phonemes that they’re working on. So one cycle could be a long time. It could take, take a while. So next let’s dive in a little deeper on those primary patterns.
Suzanne Aldrich: okay. So, um, there’s first. [00:15:00] Syllable. And this is the child who is monosyllabic. You’re not targeting weak syllable, deletion a child says Nana for banana. We’re not gonna look at syllableness. Um, but you know, if a child is saying ba or baby and ma or monkey, then you’re gonna look at that primary pattern of syllableness. Um, the next thing you’ll look at is Singleton consonant omissions. And the way I conceptualize that in my head is final consonant deletion and initial consonant deletion there’s times where you address medial consonant deletion but I feel like that’s more rare and what you’ll really the really primary patterns you’re gonna focus on are gonna be final constant deletion and initial constant deletion then you’re gonna look at S clusters and in this primary pattern you’re not looking at S clusters for the child who has um, A substitution. So a child who’s saying wide for slide. It, it, you’re not gonna target those S clusters it’s for the reduction of those clusters. So a child who’s saying dop [00:16:00] for stop or even sop first stop Um and then you’ll look at what hots and calls anterior posterior contrast or fronting or backing Um So the child who says tat for cat and you’re not obviously not gonna charge target fronting and backing it’s, you know, the child will probably have one or the other And then the last primary pattern is gliding.so the, the child who says rat for rat, or we for leaf.
Michelle Andrews: Yeah. So these primary patterns are specific phonological processes, syllable, newness, consonant omissions, as clusters fronting backing and gliding.
Tell me a little bit more about these patterns. So do I need to go in that order when I’m going through the cycle’s approach? Um, and tell me again a little bit more about, so I really can understand how long I need to treat each pattern,
Suzanne Aldrich: So you don’t have to go in that specific order. Um, but it makes sense to kind of start with syllableness, go to initial [00:17:00] constant final constant deletion. Um, but you are only gonna target the patterns that one, the child actually needs to target. So you don’t just target syllable nest to target syllable If if the child is speaking in two and three syllable words consistently you can skip that pattern Um and you also will not work on any patterns that the child is not stimulable for. That’s a big component of the cycle’s approach. The child has to be stimulable for the targets and the patterns that you are gonna address so yes I mean it’s a general outline to go in that order and then how long you’re gonna treat each pattern depends on how many sounds within that pattern the child is stimulable for So if you’re targeting um you know the S clusters if the child is only stimulable for SK and SL um those were like the worst two to pick because like, they’re the hardest, but let’s say magically, the child is stimulable for SK and SL.[00:18:00] Then you’re only gonna target SK for one hour and SL for one hour you’re not gonna target every other S cluster available to you because the child’s not stimulant for it So maybe child one is targeting S clusters for two hours and child number two is targeting S clusters for four hours. something to remember is though you will only target each pattern for a maximum of six hours. So this really comes into play with the S clusters, cuz there’s like nine or so options. For you to choose when targeting S clusters but you’re only gonna target a maximum of six of them.
Michelle Andrews: Yeah this is something I really wanna highlight because this is the main thing I’ve been confused about with the the cycle’s approach is that you do skip patterns if they can already produce that sound except for liquids Is that correct
Suzanne Aldrich: so let me be clear Let me be clear Yes You’re gonna skip patterns that the child is stimulable for so if they’re already producing That pattern in their speech why would you [00:19:00] target it You’re just kind of wasting your therapy time, right? Um, you also would skip patterns that the child needs to work on if they are not stimulable for them So those are times when you’ll skip pattern, but let’s talk about the liquids because, maybe this child is a unicorn and they can produce L’s and R’s then you would skip that pattern any other time- if the child cannot produce the L or the R the liquids you are going to target that pattern This is the only exception to the child needs to be stimulable to target the sound rule Um, so you’re always gonna target the initial L and initial R in your first and subsequent cycles Um but when you target these liquids you don’t have to set yourself up in the child up for the expectation that you’re gonna produce these perfect Ls and Rs. The main goal here when you’re working on these liquids is just “facilitate the liquids” is what Hodson [00:20:00] says You’re looking to just suppress the gliding like make the L and the R better So even though you’re going to target that initially right off the bat with every child, don’t set yourself up to think, oh my gosh, I have to elicit this perfect R from this kid You don’t you’re just trying to like I said facilitate them.
Michelle Andrews: Right. That’s so interesting with the liquids that you really need to try to facilitate that even if they are not stimulable for R and L. So tell me, I’m always interested in the science behind why we do things. , so why exactly do you work on those later developing R and L sounds when a child is very unintelligible, very hard to understand. what’s the science behind that. Why do you work on R and L with the cycle’s approach?
Suzanne Aldrich: So with the cycles approach, the idea behind facilitating those liquids is just not to reinforce. Um, that incorrect moto kinesthetic image, like you don’t want the child just con [00:21:00] you know, practicing that incorrect R and L forever until you correct all these other things first, because then you’re just giving them more time to habituate that errored pattern. So if you, and if you wait to target the L and the R before this child, um, you know, if you wait until this child corrects all these other phonological patterns, the child’s gonna be eight, nine before you get to the L and the R. So the idea is to get it in there, get it in the, the mix of what you’re targeting so that the child has exposure to it. And you’re not letting them just continually use this incorrect pattern.
Michelle Andrews: That makes a lot of sense that really does. Okay So say I have a child that I want to use this approach on how do I go about choosing target words
Suzanne Aldrich: Okay So this is really important because the whole idea of cycles is that the child has to be stimulant for these targets and they should be like easy wins, you know, they should be, they have highly facilitative context um, that make [00:22:00] the word like, like a lo for the kid to say, that’s how I think of it.So, you know, once you’ve determined your patterns that you’re gonna address and which pH names within those patterns that you’re gonna address you know, let’s say we’re talking about final contemplation and you’re gonna target final T and final P and final M um you’re gonna choose three to five words for each of those final sounds So fi let’s say five final T words. five final M words five final P words and these words are gonna be easy words. So when you’re choosing final T words you want them to have highly facilitative context. So the child can practice that word accurately and get the you know the correct as Hodson calls it moto kinesthetic pattern.
Michelle Andrews: Carefully choosing your target words is so important. My analogy for this, similar to what you said is that we’re playing, tee-ball not fast pitch. We want to help them as much as possible, but they are still [00:23:00] swinging the bat.We want the child to produce all of the target words correctly to reinforce that moto kinesthetic pattern. The child must be stimulable for those sounds and the complexity of the words that you choose are to be increased very gradually. We want those words to be easy wins. Like you said, we need them to have a hundred percent accuracy when they’re practicing, so they’re not practicing it the wrong way. I don’t need to choose words that have. Difficult sounds for the child. We want the child to focus on the sound they’re working on and produce it with a hundred percent accuracy.You want to choose just the easiest words for them to work on.
Suzanne Aldrich: You want the easiest words you wanna avoid any, sounds that are made in the same place as the errored sounds. So let’s say we’re working on that final T because the child is, um, That’s a bad example. let’s say let’s say the child is fronting and you’re working on trying to elicit the, the, the initial K. You’re not gonna choose the word [00:24:00] cat because it has a T on the end, you know, it’s not gonna that’s not facilitative. That’s gonna, that’s gonna influence that initial K and, and you’re probably gonna keep getting tat. Um, you know, if you’re working on final continental deletion, you’re trying to get VC. You know, vowel consonant shapes to make it just easier,
Michelle Andrews: right, Suzanne, that makes a lot of sense. Making the words simple for them so they can have those easy wins. Okay. So my next question is how many target words do we need per session or per pattern?
Suzanne Aldrich: So you would ideally have, you know, three to five, words for your your treatment set. and you would target them for that hour. If you have a full hour session you’re gonna target them for the full hour. If you have two 30 minute sessions, then you’re gonna do those three to five words in your first 30 minute session and in your second 30 minute session So you get that total of one hour um of that phone name and then you’re gonna move on it’s an hour per phoneme for every phoneme [00:25:00] that’s stimulable within that pattern.
Michelle Andrews: Right. So then, so, right. So even if you saw the kid for two 30 minute sessions, you would work on the same one, one day, and then also the the second day you saw them. So once I have my target words, can you outline what a therapy session might look like since it sounds like you’re gonna be asking this child to say the same words over and over again. What are some tips and tricks that you have in mind for that?, just explain kind of how that might look.
Suzanne Aldrich: Okay. So first of all, cycles has a very predictable outline the way it’s laid out in the you know in the literature You’re always gonna follow this, this outline for your treatment session. So the first thing you’re gonna do. If appropriate, you know, if it’s not session one, you’re gonna review the old targets from the previous session. And the way I do that is I just kind of flip through like the three cards that we did the last session. And I’m like, you know, what’s this what’s this what’s this um so that doesn’t have to take long and then you move on [00:26:00] to the auditory bombardment and what this is is the child Listens to a word list that contains the target that you’re gonna be working on for that day um with amplification. So, if you’re working again, like on final T the child’s just gonna wear headphones, it’s gonna be, um, amplified in their ears. And all they’re gonna do is they’re gonna be listening to a word list of all words that end in final T these words don’t matter. They can be a little more complex than what you’re gonna have them say. It’s. They all, they all end with the target of the day or they all contain the target of the day I should say after they do that auditorium bombardment which should take you know a minute to get through a word list a minute to two minutes, the child just can sit quietly doing an activity while the, the headphones are on. After the auditory bombardment is completed, you’re gonna then practice well, introduce and practice your new targets. So. , you know, the way I do this, if it’s a child who who can with cards, I will, you know show them picture cards we’ll review what the cards are what the [00:27:00] words are we’ll produce them together and then we’ll jump into whatever the activity is gonna be to produce those targets So I’ll I’ll go back to that. But then after the after the, the the practice after you’ve gotten all your practice in for the session which is the meat of your session um you’re gonna do a meta phonological activity and I like to make this activity tied to whatever the target is so I keep using this example of final T, but if we’re, you know, if we’re focusing on words with final T um, I might say, you know, in one of our targets was hat, I might be like, okay, here’s hat. Tell me which word rhymes with hat, bat or cap. And, um, you know, incorporate it that way. You know, you could also say, what sound do you hear at the end of the word Oh I hear T you know, so that any of that kind of phonological awareness activity Um but I usually like to tie it to whatever the target was and then you’re gonna do a stability check for your next week’s target.um, so, [00:28:00] you know, if you were targeting final T and you think next week you’re gonna target final P you know, just run through really quickly see if the child can produce those words with final P um, cause you know, sometimes like you’ll do the eval and you’ll you’ll think, oh, the kid, you know, this child’s gonna be able to do this. And then you get into the moment and they can’t. So you always wanna, you know, you always wanna check and make sure that your next week is gonna be a stimulable target because that’s, you know, that’s the whole point. Um, And then you finish up with the auditory bombardment again. So same word list put on your amplification listen to the the word list for a minute two minutes and then you’re done You could send home home practice.
Michelle Andrews: That’s awesome, Suzanne. Okay. So you review old targets, you do auditory of environment. You introduce in practice, your target words, do up a phonological awareness activity. Then do a stimulability check for next week’s target.Then finish with auditory bombardment. What kind of homework or home practice do you send home with [00:29:00] the parents?
Suzanne Aldrich: So this depends on the child because one we do not want them to practice anything incorrectly. Like that is, that is one of the main points of cycles. You’re always practicing accurate productions. Um, so if let’s say, if it’s a child I don’t think is going to go home and practice be able to practice the words accurately without all of the SLP assistance I’ll just send home the listening list Have the parents read it twice a day morning Night um you can send home home practice words If you’re confident that the child will be able to produce them I’ve done this in the case where the mom was an SLP Um, but I’ve, I’ve kind of rarely done that just because I do I I don’t want them to practice incorrectly. So yeah, those are kinds of a couple of things you could send home phonological awareness tasks related to your target of that week Um it just depends on the child I think
Michelle Andrews: For the auditorium bombardment, uh, homework. Do you want the parents to use headphones or [00:30:00] any kind of, is that, is
Suzanne Aldrich: I mean ideally, yeah You’d want them to use headphones So what they could even do and what I’ve suggested to parents is record themselves on their um phones like voice memo And then you can put the earbuds in that come with like the iPhone and just crank up the volume a little, you know, so it’s, it doesn’t have to be like a, like a dedicated system to amplify the sound. We can all just use our iPhones at this point.
Michelle Andrews: that’s so true. So true. All right. Let’s go over some real therapy example.
Suzanne Aldrich: Okay. So let’s let’s hypothetically start at assessment. You are assessing this child in front of you. You can use a formalized assessment or you can, you know, use an informalized measure. But what you’re going to do is address patterns that are present more than 40% of the time in a child. Speech.
So let’s pretend this hypothetical child needs to address all of the primary patterns in cycles. So you [00:31:00] would start at syllabus. And the first thing you would address there is to. Productions. What Hodson recommends is using compound words, if possible. So things like rainbow cowboy but you can also use just two syllable words like hippo. And you’re going to work on that first. I won’t call that a phoneme, but that first target set for an hour. And then you would work on three syllable productions for that child. Again, you’re going to try to look at compound words. So I like to do baseball bat, cowboy hat. So. You can kind of build off some of the two syllable compound words, cowboy, cowboy, hat, baseball, baseball bat. So you’re going to do that for an hour, then you’ve covered your syllabus. Primary pattern. The next thing you’ll look at is the final consonant deletion. So here you’ll find the final consonant that this child is stimulus for. So you’re going to work on each final consonant on its own for an hour.
So you can start with, like, let’s say [00:32:00] final T you’re going to have three to five final T target words. I can give you some examples of some good final T target words that , our facilitative and monosyllabic. So you’ll look at words like hat bat eat. If you can get a VC, a syllable shape, I think, you know, that’s your best bet. And then looking at easy CVCs so you’ll work on that set for an hour and then you’ll go to your next final consonant. Let’s say that’s final P where it’s like up hot. Map. So you’re looking for three to five target words, final P work on them for an hour with this child. You’ll go through that with final M final and all, if the child is stimulable for them once you finish final consonant deletion.
You can look at initial consultation, you can kind of flip flop those two, if you want initial consonant deletion first and then final consonant deletion. But [00:33:00] when you look at an initial consonant deletion, Hodson recommends looking at the bilabials are the things that are easy to see. Ps Bs Ms W but you can also look at T D N H.
And I always say like, Nothing is written in stone. Let’s say, if you have a child who has initial constant deletion and they need to address this pattern, and they’re not stimulus for the Ps and the Bs and the M’s, but you got, you can get them stimulable for an S or an F. I say, give it a shot that may not be textbook, but, you know, I think it’s, it’s an option that you can look at. So, you know, if you’re on the initial consonant, deletion pattern, and you’re looking for. Words that start with, let’s say initial B, you’re going to look for CV shapes if you can, boo bye and then CVC would be your next bet because you want those, you know, monosyllabic, highly facilitated context. After you go through initial consonant deletion, you can look at fronting or backing. Let’s say [00:34:00] this child is fronting. So you’re going to start with initial K final K and initial G you don’t want to work on voice final stops because it encourages that intrusive schwa like bag-uh and the theory too also is if you get the final voiceless. Carry over to the final voice. So when you’re looking at fronting or backing, you know, you’re not going to do final G are not going to do final D. But if you’re targeting final K as your first set in that fronting primary pattern, you’re going to look at words like bake and ache and to, you know, again, get VC syllable shapes or easy CVCs. You’re not gonna include words that have or you’re going to try not to include words that have sounds in the same place as the errored sound. So I try to avoid in this case, all alveolars. So I don’t like the word sick for a child who [00:35:00] is. Fronting cause the S is made in the front of your mouth and then you’re trying to get them to the back for a K. That would be a later cycle. Like I might try to throw a word like that in when I want to increase the complexity a little bit. And then, so, you know, your target, your final keywords for an hour, and then you just move on, you target your initial keywords for an hour, your initial G words for an hour and move on.
And then once you do all of that, you’re going to look at your S clusters. And this is where a lot of your time is spent because there’s so many options for S clusters. Or maybe you don’t spend a lot of time because the child’s not stimulable for any of them. But let’s, let’s hypothetically say this child is a unicorn and stimulable for all of the possibilities in the S cluster primary pattern. You’re not going to target every single one because you’re only going to target a max. Six sounds in this, in any primary pattern. So you can look at final TS and that’s where it’s like, I like plurals, like hats, bats, cats target that for an hour.[00:36:00]
You can look up final PS and it’s the same idea. Maps, hops. Oops. And then you can also look at final Ks, but a lot of times the child’s not stimulus for that K. So that’s when I, I usually end up skipping. But you can do books, bikes And then you’re looking at your initial S clusters. So initial S P words you’ll look at for an hour where it’s like spin, spill spot initial S T stop, stay And then if you get to like initial SN and initial SM, cause again, you’re only, you’re only focusing on six where it’s like snow snap snack is an okay one that K sometimes throws, throws kids off SM small smell, smile. I feel like those are hard a lot of times because of the, because of the words that start with SM there’s always some like difficult phoneme somewhere embedded in that word. So sometimes those are, if I can, I will skip like SM because like I said, there are so many as cluster options. [00:37:00] So you can you know, you’re going to, there’s some that you’re not going to address. And then you’ve got to the, the gliding, the, the, the piece that you are never going to skip unless the child is producing initial R. And in this initial L in their speech, then obviously we’re going to skip it. We don’t need to address something that the child is capable of doing. But you’re always going to address initial L and you’re always gonna address initial R regardless of stimulability And you’re going to work on just facilitating better production, suppressing the gliding. You’re not looking for perfect Ls. You’re not looking for perfect RS. Although I will say it’s easier to get a pretty good L sometimes Then an initial R and so let’s say you’re working on your initial R words for your hour. You’re also going to want to look at words that have facilitative context, even though, you know, you’re not shooting for perfection. So I’ll look at words with like high vowels, like read or you know, even sometimes the. It all depends on the kid, which, or word is facilitative. So [00:38:00] I kind of run through a few different vowel options to see which one hits with the kid or which area on the vowel contralateral we’ll hit with the kid. And same for initial L you know you’re not gonna want to do a word like I’m trying to think of a word that has a, a glide somewhere in it, like sometimes lay and low or a little more difficult. But they’re nice syllable shapes. So who knows, you know, you just kinda gotta give it a shot. And then you hit, you’ve hit all of the primary patterns and all of the phonemes within those primary patterns at that point. And you’re at the end of a full cycle for this child who needed to address every pattern.
Michelle Andrews: that’s perfect. That really just clicked in my mind to be able to hear all those examples. That was so helpful
Suzanne Aldrich: Yeah, and I, I always find that if I see it visually, rather than just explaining it, like, as soon as you see a visual, it clicks for people. They’re like, oh, this makes sense.
Michelle Andrews: So let’s talk a little bit about when it’s time to move on.
Suzanne Aldrich: So from cycles in general or from a particular pattern
Michelle Andrews: let’s [00:39:00] start with, um, let’s talk about both. Let’s start with each pattern
Suzanne Aldrich: Okay So you’re gonna dis discontinue targeting a pattern when you start to hear it emerging in a child’s conversational speech and to me, I, I follow the general guideline of 40 to 50% of the time you know when you’re first evaluating a child for use you know, to see if they’re appropriate for the cycle’s approach. The recommendation is that they, they show these deviant phonological patterns more than 40% of the time in their speech So that’s the guideline I go off of when I determine like okay it’s emerging in conversation more than 40 to 50% of the time um so we can discontinue using that uh pattern um Particular phonemes within the pattern If you start to hear like let’s say you still don’t hear final consonant deletion resolving enough but you start to hear like final T is coming out pretty consistently. you can remove the final T from your final consonant [00:40:00] deletion line but still target final consonant deletion with the other phonemes if you’re not hearing them does that make
Michelle Andrews: Yeah Yeah that makes sense. Okay. so what are some signs that this approach is working well for a specific child versus when it might be time to move on from the whole cycle’s approach Like how do you know that this approach is is working well for your specific client?
Suzanne Aldrich: So a lot of the research will say it takes two to three cycles to even see you know Improvements in the intelligibility So first like I would say don’t, don’t give up right away. Um, if you, you know, you go through one cycle and you’re like this isn’t working, it doesn’t generally work in one cycle. but I would say if you are seeing improvement, you know, if the child’s a bunch of the patterns start to resolve and the child’s becoming more in intelligible, like they become, if now their chronological impairment is mild to moderate versus moderate to severe Um then I would say look at the approach again, and maybe you can change it to something else like at that time sometimes I’ll switch to minimal pairs or something like [00:41:00] that. That’s not as, um, you know, not as geared towards somebody who is more severely, you know, on the severe end of the phonological disorder spectrum. you know, and I also think you have to look at the child -like are they are they having a good time with this approach? You know that’s that’s a thing I consider you know is the child is the child you know they come to speech and they’re like this I can’t do this I don’t wanna do this, um You know maybe you need to find another approach. I think cycles is one that a lot of kids feel good about because you’re only addressing those stimulable sounds so they’re successful a lot of the time. Um, but you know, there, there are those cases where you, it might just not fit with the child. You think it’s gonna fit with.
Michelle Andrews: Right. Right. And I love how you talked about how you’re not gonna see progress right away. And I know that’s where I struggle in therapy. The most, you know, you have a parent bringing their child and you’re like, I want, I want you to have progress every session. And it be amazing. I just have to remember that every kid, every situation may be a little bit different, but shoot for that one hour a week as [00:42:00] best you can, it is hard when parents ask for a timeline or they’re paying out of pocket and you want to see results right away. But remember to be patient and consistent because. That’s when you see the progress.
Suzanne Aldrich: I have the same problem Like I want immediate results and I know that’s not always the case And remember one cycle like one cycle itself could be 12 to 14 weeks and that’s if you have the full hour session So if you’re let’s say you’re seeing the child for an hour a week and you’re targeting one phone name within a pattern each week you may have 12 to 14 D targets 12 to 14 different weeks where you you know to get through the first cycle So what is that three months? Yeah, I mean, three months before you’re even through the first cycle. So now times three is nine months.
Michelle Andrews if you’re, yeah. If you’re doing 30 minute sessions or. Yeah, that would, that would take a long time. Do you [00:43:00] often then also recommend to parents hour long sessions Of course this would be you know in the schools you might not always have the flexibility for this, but what do you recommend to parents when you’re setting up your treatment plan
Suzanne Aldrich: I’ll be honest like for me because I have the luxury of working in private practice I prefer two 30 minutes a week just because they’re so little I I rarely meet the four year old Who’s like I’m gonna sit there for an hour and we’re gonna work you know I I don’t think that’s I, don’t think that’s, out of the norm I think that’s a lot of four year olds. So if I can, two 30 minutes to me is even it’s more, um, desirable than the one 60 minute, but you know, you work with what you have.
Michelle Andrews: Right. Having their full attention is a lot better than just forcing it for even longer.
Suzanne Aldrich: right Yes You could you could force the 60 minutes and say oh I did my full 60 minutes in a week but like was it a good 60 minutes You know could it have been better if it was you know two 30 So that’s how I look at it. And in [00:44:00] those young children, those that are nonverbal, those unwilling to participate can go through a cycle still that just focuses on auditory input for their primary pattern.
Michelle Andrews: Suzanne, have you gone through an auditory input cycle?
Suzanne Aldrich: I think doing something like focused auditory, In combination with a sort of stimulus ability approach is more the route I take, because like you said, yeah. Okay. It’s great that we’re just going to bombard them with final P words for an hour, and then we’re going to bombard them with final T words for an hour. Cool. But I also still try to get them to produce something for me, like become more stimulable for sounds because you’re just listening. Who knows if I’m. You’re going to be then be able to produce it. So I kind of hybrid focused auditory input with like stimulus ability and do that route, which again is, you know, not textbook and it’s not in this, in the literature but I feel like that’s real world.[00:45:00]
Michelle Andrews: Right. That makes, that makes the most sense to me. Let’s see. Do you have a story where you decided to not did the cycles approach
Suzanne Aldrich: I just, I feel like a lot of the unintelligible preschool. Can benefit or usually are pretty appropriate for the cycle’s approach. But, you know, there are times where I will come across a preschooler who just has a few phonological errors. And at that point I’ll do something like minimal pairs. Or if I have a preschooler who has something like a phoneme collapse, I’ll, I’ll try to get, uh, multiple oppositions going um, so a child like those, I might, I wouldn’t probably consider the cycles approach first.
Michelle Andrews: That’s great. Suzanne, can you tell me more about why and how the cycle’s approach works? What is actually going on in there? So to speak, how, how does it work?
Suzanne Aldrich: Yeah, so like there’s a few theoretical concepts of why, you know, the cycle’s approach is beneficial. And the first one is that children, typical children acquire phenology gradually. Like we [00:46:00] don’t learn all P first and then, and then we move on to M and then we move on to B. So the idea is you work in that cyclical fashion to mimic basically how, children typically acquire their phonology. and then another important component or theoretical underpinning of the cycle’s approach is that normal speech is acquired by listening. We just, we listen, we hear and we repeat. So that’s why that auditory bombardment piece is important. It’s to, you know, draw attention to that audio, that maybe the child’s not getting just normally. So, you know, you’re, you’re giving them that extra boost of, listening. because, you know, the theory is that’s how we normally acquire our phonological system.
Michelle Andrews: Exactly parents. Aren’t out there teaching their babies and toddlers, where to place their tongue, how to produce each sound. They hear it and perceive it. Then eventually try to produce it and hopefully produce it correctly. Tell me a little bit more why we only wanna use stimulable [00:47:00] targets when we’re choosing our target words.
Suzanne Aldrich: Um, you know, we’re only using stimulable targets with facilitative context cuz another component or theoretical underpinning of cycles is that, we only want the child practicing correctly. We don’t wanna reinforce the wrong kinesthetic image. We don’t wanna reinforce the wrong motor pattern. The other reason, another, another theoretical component to the cycles approach is that, why we’re using those stimulable sounds and, um, patterns is because we wanna work within the child zone of proximal development. So like just a level above what they’re not they’re doing now.
Michelle Andrews: Yes. So they’re challenged, but they’re successful
Suzanne Aldrich: So, um, it’s still challenging, but they’re successful. and that leads to, you know, quick. learning and generalization. so those are some of the reasons why the cycle’s approach is designed the way that it is.
Michelle Andrews: [00:48:00] that’s so interesting. I love to hear about the science and the why I’m doing something. You know, I, I feel like I do better if I know what it’s actually doing in the brain and, why it’s gonna work. That’s really neat.
Suzanne Aldrich: I, I agree.
Michelle Andrews: So say, um, you have a kiddo that is absent a lot, you know, does that really throw things off?
Suzanne Aldrich: Mm I would say yes. I mean, you wanna be consistent, you know, you wanna, the, the idea is you have your two 30 minute sessions in the same week, your four, 15 minute sessions in the same week. You know, it’s not a 15 minute on Monday, a 15 minute on the next Monday.and then a 15 minute, the following Monday, it all needs to kind of be consolidated within that week. You know, there is some wiggle room. Two thirties and the four fifteens. Um, but you, you know, they should be within the same week. So a kid who’s absent a lot. Maybe I don’t, you know that what approach is gonna work for that kid? I, you know, they’re just not there So cycles minimal pairs. It doesn’t, I don’t [00:49:00] think it matters at that point.
Michelle Andrews: I know in, in the private practice, I, I had a, a kid. I had several kids that, you know, maybe all they could really, before it is to do an every other week. And I, some people, you know, if you’re, if you’re transitioning out, that’s fine I would just didn’t recommend it often.So yeah, an approach like this, you would probably just have to have it talk with the parents. You have to work with what you have now, Suzanne, I’d love for you to describe some therapy activities that work well for this approach.
Suzanne Aldrich: Okay. So I’m, I’ll, I’m gonna tell you about some of my go-to, um, cycles activities. So I, I kind of think of the, this in two different ideas. One is the kid who you can sit down and drill with the cards and the worksheets and the other is the child who you have to focus on play-based activities. Um, I don’t think either are wrong and I think there is a time and a place for both. And, you know, we can get on that soapbox another time, but I don’t think there’s anything wrong with cards and drill if the child’s gonna do it. And it works for that child. [00:50:00] So, you know, if you have that child. take out my cycles cards. , you know, I have them say the word five times, and then we get a turn in, , like a fast turn taking game, you know, crocodile dentist, pop the pig, all the go-tos that you can take a quick turn and then move on. Um, so I’ll do you know, I’ll do things like that. I have, um, you know, full disclosure, self-created worksheets geared towards the cycle’s approach, um, with all the primary patterns that I’ll use, that you can, you know, you can get quick high repetitions. That’s not for every child, not every, child’s gonna sit there and do that with you, but, um, that’s another option. And then there’s the child who you have to go full on play based. And these are kind of my favorite kids because. I love the challenge of trying to figure out how to fit my target words into whatever the play scheme is. So, let’s say we’re targeting, uh, final tee and the child wants to play with, um, train tracks. now I have to come up with final tee [00:51:00] words. Better facilitative and easy for the kid to say that I can work into our play. Um, and I think that that is the fun challenge. I mean, you know, you always have words like out and hit that you can pull from, you know, there’s a list that you can go to and then try to figure out how to, how to incorporate those words into your play. Um, but yeah, that’s, you know, that’s another way to, to go about targeting all those words. I have my own lists of target words. So I just, you know, even if I’m gonna do play based, I whip out, you know, the cards or the list. And I say, okay, how can I work in, um, you know, man, and band and moon into this game, whatever, you know, whatever the words happen to be.
Michelle Andrews: Awesome. So some high repetition, quick turn games, worksheets play based activities with on topic, target words, some days I’m really good at thinking of appropriate target words during play on the spot. And some days [00:52:00] I definitely need to have a list I can look at, I love hearing all of your ideas for therapy that have the child producing lots of repetitions. That’s.
Suzanne Aldrich: Yeah. And I, you know, I think that there’s a, you know, just, I gave you like kind of three different tracks that you could go, you know, you could do the cards, cards, drill quick game. You could do worksheets if the child’s gonna go for it or play based, you know, and it all depends on the child in front of you.
Michelle Andrews: Right. Yeah. And also maybe mixing it up, doing some of all of those and have, have them have options.
Suzanne Aldrich: absolutely. Yeah, you could do, you know, a couple of minutes of drill, move on to a play game, you know, play based activity and then go back to even the drill.
Michelle Andrews: I don’t know about everyone listening here, but I know Suzanne and I were talking about how we’re very visual and we need to see things sometimes. If you want to have something, you can hold in your hand and to look at that really spells this out. Suzanne does have a lot of cycles approach visuals and tools. Suzanne, can you tell me about some of the great resources that you have created?
Suzanne Aldrich: The cycle’s [00:53:00] complete toolkit. So I have that, but even, you know, I also have a little freebie on my teacher’s pay teachers store that it’s like, It to me, I love looking at it because it’s, it lays out all the primary patterns and it lays out all the phone names underneath those primary patterns that you can target. And it just, once you see that visual, you’re like, oh, this makes so much sense.
Michelle Andrews: Yeah, it is so helpful to be able to see it all mapped out. I will link your cycle’s approach, visual in the show notes for anyone to download that for free.
Suzanne Aldrich: Yeah, I feel like it’s so hard to verbally explain without a visual component. Like here’s the primary patterns and here are your targets within those patterns. Um, so, you know, always having a visual is easier for.
Michelle Andrews: Right. Even as you’re talking, I tried to like make little brackets of, of patterns and I kind of drew it out even, even though I just wanted to like visualize as you were talking if you’re out there on a run or driving a car, you definitely don’t need to be looking at a paper, but you can, [00:54:00] later on, you can later on go look, , look it up or, or you can definitely use an already made, cycle’s visual. Suzanne, let’s give a quick summary of what you have taught us here today.
Suzanne Aldrich: So just to summarize, you know, the cycle’s approach is a phonological intervention. You’re gonna use it with children who have a phonological disorder. You’re gonna use it, with children who are highly unintelligible, you are going to target only primary patterns and phonemes within those primary patterns that the child is stimulable able for.
There are specific primary patterns that you should look at when using the cycle’s approach and that’s syllable. Initial consonant, deletion final consonant, deletion, S clusters, fronting or backing and gliding. , and you’re gonna target each phoneme within those primary patterns for an hour, and then move on.
You’re not working towards any level of mastery. You’re just working for that hour and you move on. Um, when you’ve completed [00:55:00] all of the primary patterns and all the phone names within that primary pattern, then you’ve completed one full cycle. When you choose their target words for those phonemes within the primary patterns, you wanna choose target words that are, monosyllabic and highly contained, highly facilitative context. , these words need to be easy for the child to say so that they are practicing them correctly. Um, almost every single time, you know, that’s, the goal is a hundred percent accurate productions. , I know that’s comp not completely attainable, but that’s the lofty goal,
Michelle Andrews: yes. A lofty goal. But yes, that a hundred percent accuracy is important and these words need to be just challenging enough, but where the child is still successful.
Suzanne Aldrich: right? it doesn’t really lead you with a lot of options for target words. I’m gonna be honest. You know, when I was coming up with wordless for targets, you really have to consider the, the, the words that you’re choosing. So, you know, if you, if you’re having trouble with that, I, I do have a, I do have wordless, um, [00:56:00] that will make it easy for you. Um, Because I really don’t think that there’s actually that many options. When you think about using highly facilitative monosyllabic words, um, it narrows your field a lot.
Michelle Andrews: Yes, that might be our take home point from this entire podcast episode is when choosing your target words for the cycle’s approach, think of those highly facilitative monosyllabic words. This has been so great, Suzanne. I have really enjoyed it. Having you on this episode and really enjoyed chatting with you. This episode has been so informative. I am so thankful for Suzanne and all she has taught us here today. I hope you guys are able to go out there and feel more confident with the cycles of. Be able to efficiently choose target words that can best help your students. I know I’ve learned a lot here today and I am so thrilled to have you here, Suzanne.
Thank you for listening. We hope you learned something today. All of the references and resources throughout this episode are listed in [00:57:00] the show notes and also listed on the pep talk podcast for LPs website. If you’ve been listening while you’re driving on a run, doing the dishes, this entire episode is transcribed for you to refer back to easily.
Suzanne, thank you again for joining me today. You have been so.
Suzanne Aldrich: Thanks for having me.
Michelle Andrews: Yeah. And if you are listening and you want to learn more about Suzanne, you can find her on Instagram, Facebook, she has a website, or you could email her with any questions firstname.lastname@example.org. Thank you so much, Suzanne.
Suzanne Aldrich: Thank you. It was good talking with you.
Michelle Andrews: Anytime, Suzanne. I hope we can have you back soon.
Click Here for Suzanne’s Free Cycles Quick Start Guide
Hodson, B.W., & Paden, E. P. (1991). Targeting intelligible speech: A phonological approach to remediation, 2nd Ed. Austin, TX: Pro-Ed.
Hodson, B. W. (2011, 4/5/2011). Enhancing phonological patterns of young children with highly unintelligible speech. The ASHA Leader.
Hodson, B. (2006). Identifying phonological patterns and projecting remediation cycles: Expediting intelligibility gains of a 7 year old Australian child. Advances in Speech-Language Pathology, 8(3), 257-264.
Prezas, R. F., & Hodson, B. W. (2010).The cycles phonological remediation approach. In A. L. Williams, S. McLeod, & R. J. McCauley (Eds), Interventions for speech sound disorders in children (pp. 137–157). Baltimore, MD: Paul H. Brookes Publishing Co.
The contents of this episode are not meant to replace clinical advice. Pep Talk Podcast, its host, and guests do not represent or endorse specific products or procedures mentioned during episodes unless otherwise stated.
TSHA approval does not imply endorsement of course content, specific products, or clinical procedures.