Multiple Oppositions Approach (MOA)

This is a paper I have to hand in tomorrow. As you can see it is a group paper.

Multiple Oppositions Approach (MOA)

Presented by:  April Hoyt, James Larkin, Lauren Pagnard, Megan Quimby and Shanna Siporin

Introduction

MOA was created by Lynn A. Williams at East Tennessee State University.  Research suggests that it is an excellent way to help clients with multiple errors and should be used more frequently.  Lynn A. Williams states that as this becomes more commonplace, the way SLP’s diagnose will advance as well.  They will concentrate more on the system and its errors and less on each specific sound error.  As a group, we were only able to find one or two SLP’s who uses this approach.

What is it?

v      Alternative contrastive approach in phonological intervention for treatment of severe speech disorders in children

v      Premise is that the systemic level of phonological organization is essential in the description and intervention of disordered sound systems

v      Used to remediate troubles with homonyms and to contrast errors with multiple targets.

§         Example:  “……a child who collapses the voiceless obstruents /s, sh, k, ch / to [t] would pronounce the words sip, ship, Kip, and chip all as [tIp]” (Williams, 2000). 

v      MOA uses this collapse to introduce to the client that there are differences in words that they previously could not distinguish from.

Target Clients

v      Mainly used with children 3 & 6 years of age, but can be used with any population group

v      Children with a minimum of six sounds across three manner categories excluded from their phonetic inventories

v      Suitable for children who exhibit severe speech disorders

Process - “The most important part of the MOA is the initial assessment” (Williams, 2000). 

1.      Analyze the child’s errors to obtain a detailed understanding of how to proceed forward with treatment

§         Initial assessment of child’s speech takes two hours

§         MOA uses 200 pictures instead of 20-50

§         This allows the determination of rules and sounds that are part of the child’s language.

2.      Select treatment targets

§         Begin with knowledge of child’s unique error patterns (eg: /s, sh, k, ch / to [t]) and targets must be:

·         Maximally distinctive from the child’s error

·         Salient, therefore presumably more learnable

3.      Treatment should occur twice a week for 30 minutes/session

§         Error sound is presented by the first treatment card

§         Target sounds are represented by subsequent treatment cards

4.      Begin with imitative phase until 90% accuracy across two consecutive training sets are reached

5.      Progress to spontaneous phase

Outcomes

v      By helping them understand the extent of change necessary, they are able to use the correlation for all the sound errors to make connections about phonologic strategies and revise their current strategy. 

v      This is an excellent approach as it requires the clinician to individualize each case.  Each child has a different system and this approach creates a unique intervention.

Benefits

v      Though the average time under traditional approaches is between five and seven years, this approach took between one and two years before children were released.

v      After participating in the MOA treatment program, the average improved 85.1% however one child improved from 14% to 99% in 19 months of treatment.

Cycles Approach: A brief intro        

v      “The cycles approach was developed [by Hodson and Paden] for use with children with highly unintelligible speech.” (Shulman, B.B., & Capone, N.C. (2009)

v      The client is given quick exposure to the desired target and then given time to “internalize, sort, experiment with, and do self-rehearsal” (needs a citation?) as they would normally do within typical language learning. 

v      Introduces new targets before old ones are mastered.  .

v      Helps “synchronize” two of the methods of learning: kinesthetic and auditory; and to encourage the client to learn on his/her own. The client is expected to learn new rules for producing sounds as their current rules are not working. 

v      Hodson and Paden state that many preschoolers require less than a year of their intervention to become intelligible. 

v      Research suggests that this approach is more efficient than other approaches because it targets and fixes more speech sounds in less time.

Multiple Oppositions vs. Cycles Approach: A Comparison

                             MOA                                                       Cycles Approach           

Designed for: Children with severe-profound phonological impairment who substitute one sound for several phonemes	Designed For: primarily highly unintelligible children
Focuses on: system wide change, addressing the child’s error rule as a whole unit	Focuses on: Change through listening, gradual phonological change, child as actively involved in change
Process: Targets multiple substitutions at the same time-don’t need to do all-child should generalize, targets maximally opposing phonemes with the rule	Process: Targets addressed for a set amount of time (not accuracy, rules are placed in developmental order in a specific timeframe, when time is up the next rule is targeted, after all rules are targeted the cycle begins again with the first rule

References

            Berman, S., Garcia, D., & Bauman-Waengler, J. (2007, November). Cycles Approach and Integral Stimulation: Outcome Measures for Unintelligible Children.  Poster session presented to the American Speech-Language-Hearing Association, Annual Convention.

            Hassink, J.M., & Wendt, O. (2008, June). A Critically Appraised Topic on the effectiveness of the Cycles approach for phonological disorders. International Child Phonology Conference, Purdue University, West Lafayette, IN.

McElligott, Maureen. CCC-SLP. Hemet Unified School District. Idyllwild, California.

Shulman, B.B., & Capone, N.C. (2009). Language development: foundations, processes, and clinical applications. Sudbury, MA: Jones and Bartlett Publishers.

Williams, A. L. (2000).  Multiple oppositions: Theoretical foundations for an alternative contrastive intervention approach.  American Journal of Speech-Language Pathology, 9, 282-288.