An Orton-based operant program for auditory language learning disorders.
This paper describes an Orton/Gillingham-based remedial program focusing on the temporal aspects of auditory language learning disorders. The program utilizes a Skinnerian operant paradigm which generates S-R data under strict psychophysical and psychoacoustical controls. Cumulative baseline recordings are generated and used to relate multiple -component (dichotic, diotic, ipsilateral, etc.) auditory stimuli to a listener's discrimination and synthesis of complex speech. The Dichonics[TM] methodology isolates temporal aspects of phonemic synthesis, discrimination and awareness. Comorbidity of ADHD, CAPD, apraxia, aphasia, dyslexia and autism is discussed.
Keywords: Orton, operant conditioning, language disorders, dichotic, temporal auditory, phonemic synthesis and discrimination, CAPD, ADHD, apraxia, dyslexia, autism; Dichonics
It can be argued that the treatment of language disorders should follow a strict behavioral protocol regardless of the etiology of the disorder (e.g., aphasia, apraxia, autism, ADHD, CAPD, etc.). However, this is rarely observed in practice. For example, a recent internet survey revealed that 111 different therapies were being provided to children with autism, including an average of seven different treatments per child (Green, Pituch, Itchon, Choi, O'reilly & Sigafoos, 2005). Speech therapy was found to be the most common intervention, followed by visual therapy, sensory integration, and applied behavioral analysis. Other therapies included medication (52%), special diets (27%), and vitamin supplements (43%).
According to Green, et al, (2005), professionals should address the treatment processes and outcomes rather than focusing on causation. Consistent with Green et al's recommendation, this paper presents an integrated multi-component paradigm for measuring and modifying the operant behavior of persons who (regardless of etiology) demonstrate depressed auditory language learning skills. Presented is a rigid operant (instrumental) program of the type described by B. F. Skinner (1938). Operant "conditioning" depends on growth and character of baseline as a measure of quantity and quality of a stimulus-based response paradigm. This article addresses both therapy and "diagnosis" in that a well-controlled therapy program builds a baseline of performance that reveals concise diagnostic information.
In a good operant therapy paradigm, diagnosis goes hand-in-hand with therapy. Baseline acquisition, under strict behavioral control, is a measure of learning ability (or disability) and of how the stimulus delivery must be manipulated in order to overcome failure to achieve baseline with "normal" patterns. The strength of operant conditioning is the control that can be manifested via the tight one-at-a-time manipulation of ongoing behavior so that the acquisition curve reveals ongoing information about ability. Dalton, Allen, Henton & Taylor (1969) used a Skinner box and the behavioral method of conditioned suppression (CS) to establish auditory thresholds in monkeys being employed as subjects in the early space program. CS occurs when the subject is shaped to associate key pressing with positive reinforcement but ceases to lever-press in the presence of a discernable stimulus (in our case sound). Dalton & Allen (1969) applied those same techniques to measure auditory thresholds in the adolescent rhesus monkey with induced cerebral palsy. In that study the response mode (lever) had to be especially adapted to participants with no subsequent effect on the audiogram. The thresholds were accurate, easily replicated and sensitive to medical changes as validated by post mortem examination. In an effort to establish an operant-controlled phonemic discrimination task for human application, Dalton (1979) expanded the single lever response key to determine listening preference of the rhesus monkey. Two major findings came from that study. First, the participants appeared to find a preference to what they listened to; and second, reinforcement was a combination of the listening choice and food. The results were generalized to surmise that the choice of sound became a primary reinforcer and reduced food to a secondary role. The application for behavioral therapy in learning disabilities (LD) became immediately obvious.
Learning Disabilities have become a major educational problem that grows according to the number of specialist involved. Each specialty has its own unique name for a syndrome, which to another specialist might bear a different name. Dyslexia, specific language dysfunction, specific learning dysfunction, attention deficit hyperactive dysfunction (ADHD), minimal brain damage (MBD), central auditory processing deficit (CAPD), aphasia, hyperactivity, apraxia, autism, Asbergers's syndrome, and pervasive development disability (PPD) are but a few of the labels placed on children who may be unable to thrive in a public school environment. Each specialty is likely to offer its own diagnostic methodology including educational, psychological, psychiatric, neurological, behavioral, nutritional, genetic, and others, resulting in long lists of "symptoms," all describing the same set of kids. The problem lies in that each child with LD may present a different set of symptoms. These symptoms then become the point of focus, resulting in a referral to a specific specialty that will then label the child according to the practices of that specialty. Levy & Hyman (2005) stated that in no area of developmental pediatric practice does more controversy exist than in the choice of treatment for individuals with autistic spectrum disorders. Dalton, McKenzie, Kolosseus & Barry, B. (1992) noted that dichotically evoked auditory brainstem potentials for children labeled ADHD, CAPD, dyslexia, and others consisted of the same temporal discontinuity suggesting a common root problem. Lilienfeld (2005) notes that although there exist substantial scientifically supported treatments for childhood psychiatric (speaking of PPD) disorders, many of the most popular are based on weak or nonexistent data.
Language is crucial for communication and socialization. It should be assessed systematically and uniformly before any diagnosis is made that involves language as a part of the syndrome. Responsibility for this assessment typically falls to the speech-language pathologist (SLP) and often in a school-based setting. As such, some SLPs may be influenced by the referral source, consequently designing a diagnostic and therapy plan around the labeled disorder (i.e. autism) rather than around the strengths and weaknesses of the child's language system. Too often inadequate vision and hearing testing precedes a speech and language exam as well (Wray, Silove & Knott, 2005). In these cases, the observation of Levy & Hyman (2005) holds true. Consistent with the framework of evidence-based practice, Lilienfeld (2005) suggests that the challenge for the future is to develop scientific validity to the treatment of childhood disorders.
The Orton-Gillingham (O-G) approach to phonics is, by far, the most adhered to (if not revered) phonics program ever conceived. However, there is an almost religious attachment to the "original" methodology. Many clinics, individuals, groups, and organizations are dedicated to the process. A Yahoo search for "self-contained computer-generated Orton-Gillingham applications" yields 103,000 "hits" consisting of mostly advertisements with no detailed description of the techniques used except to reiterate the O-G philosophy and/or to offer services/products for sale along with praise via testimonials.
A similar Entrez-PubMed search found two articles. Higgins & Raskind (2004) used computer software to present a speech recognition-based Program. No comparison to the classic O-G delivery system was made. One study, Guyer & Sabatino (1989), placed college students with LD on a "modified" O-G program and compared their progress to those exposed to a nonphonetic approach. Pre/post-test results were based on standardized tests such as the Wide Range Achievement Test-Revised and Woodcock Reading Mastery Tests. The O-G group was found to achieve statistically significant improvement in reading when compared to the group using the nonphonetic approach (or nothing). This study indicates that a modified O-G approach is useful in the teaching of reading to college students with LD. Oakland, Black, Stanford, Nussbaum & Balise (1998) conducted the only study that systematically compared face-to-face therapy with that provided artificially. They used the O-G methods and reported that students displaying dyslexia demonstrated significantly higher reading recognition and comprehension than a control group, even when presented by videotape. Dalton & Kolosseus (1983, unpublished data) compared a computerized Orton-based program to therapy provided by a tutor in a traditional O-G setting and found the instrumental program to be better received by the students and to result in more rapid changes in phonemic performance.
The O-G procedure is preformed using a deck of picture cards (available from many sources) for the visual stimulus and the voice of the tutor as the auditory carrier. Sounds are introduced systematically beginning with a vowel and several consonants such as "ae" (as in "apple"), /p/, /s/, /f/, /m/ and /t/. The teacher produces the sounds in isolation while pointing to the card with a picture of an object whose name involves the target vowel sound. Next, the consonants are blended with the vowel. Additionally, the child imitates the model produced by the teacher and points to the picture. This is expanded letter-by-letter and sound-by-sound, until full blending takes place. All the time, the student is writing the letters and learning to blend them into words (Orton 1964).
Dalton & Cooper (1973) (see Dalton & Kolosseus, 1983) used that approach as a guide to a computerized operant program (written in DOS 2) called Phonemic Gobble (PG). The stimulus phoneme (SP) was presented by the therapist (or produced by the student) with the computer keyboard serving as the response "lever." Since the keyboard also served as the tactile interface the home keys (/f/ and /j/) were introduced first. Once baseline for the home keys was met, the Orton (1964) sequence was begun with special monitoring to ensure that the student used proper fingering on the keyboard. New SPs were added as baseline improved. Following a period of drill with the SP, a Pac Man-like game was introduced with the current SP (and home keys) being placed on a full screen X-Y matrix. The computer cursor moved in a straight line (the only choice at that time) until the student altered directions using the keypad arrows. Hazards were placed on the grid that would end the game if not detected by the student. Additionally, some letters were given the role of "bad guy" while others were "good guys." For example, /b/ was a "bomb" that ended the game and /p/ was power that allowed temporary immunity from "bad guys." The vowels were programmed to "jump" out of the way of the cursor thus always avoiding capture. The letters were paired according to usage reversal tendencies (/b/, /p/, /q/, /d/, etc.). Dalton and French (2002) obtained a trademark for a program called Dichonics[TM] more fitted to the rapidly changing computer technology.
Spatial and Temporal Factors
The O-G program is one-dimensional. Dichonics addresses the role of temporal integration into the therapy while using the O-G approach as a linear template. The nature of temporal theory is far too complex to detail here, but, since it is integral to the Dichonics program, a brief discussion is presented.
The auditory neural system is interactive with each side contributing invaluably, and sometimes exclusively, to the other (Stecker & Hafter ,2000). Disturbing the dichotic interaction results in central auditory processing discontinuity, which interrupts the sensory integration systems involved with language acquisition and usage.1 Liegeois-Chauvel, de Graaf, Laguitton & Chauvel (1999) noted that speech perception requires cortical mechanisms capable of analyzing and encoding successive spectral (frequency) changes in the acoustic signal. A defect of this mechanism could account for hearing discrimination impairments associated with language disorders. Dalton (1971) and Boehm and Dalton (1971) described a non-linguistic stimulus (minimal auditory intensity differential, MAID) useful in the differential diagnosis of cochlear/retrocochlear hearing loss. Subsequent research placed the MAID stimulus in an adjustable dichotic arrangement (virtual image analysis, VIA) with the ability of leading (or lagging) one ear over the other in steps as small as eight microseconds. If there is no time delay between ears (diotic) the click will appear to be slightly off-center in about 80% of listeners. If the delay is changed one ear over the other, the stimulus will appear to move to the center, or further away from center depending on cerebral dominance. The wider the time gap the farther away from center the stimulus appears until, ultimately (about 1200microsec), the stimulus is perceived as being in a single ear only. Using participants at-hand, a modified method of adjustment was used to have the listeners adjust the time differential until the click appeared to be in the middle of their head. The outcome revealed that "normal" right handed listeners indicated a position slightly toward the right ear for center while left handed listeners placed the stimulus just the opposite. (2) Extensive subsequent studies (Dalton & Kolosseus, 1996, 1995, 1991, 1986,1982, 1981; Dalton, McKenzie, Kolosseus & Barry, 1992 and Dalton and Cooper, 1985) showed the VIA to be useful as the stimulus for both behavioral and electrophysiological diagnostic procedures, and it is an important part of the Dichonics program.
Tallal and Stark (1981) used operant methodology to investigate discrimination of various temporal and spectral cues. That near-classic study progressed into a study by Tallal, Merzenich, Miller and Jenkins (1998) that revealed that timing cues present in the acoustic waveform of speech provide critical information for the recognition and segmentation of the ongoing speech signal. They devised a therapy that depended on the reduction of temporal integration thresholds via a computer algorithm that expanded and enhanced the brief, rapidly changing acoustic segments within ongoing synthesized speech and used this to provide intensive speech and language training exercises. Oades (1998) discussee the importance of cross-hemispheric dialog with information supplied by the contralateral system. The presence of visual correlates in linguistic processing (Elias, Bulman-Fleming & McManus, 1999) offers additional evidence supporting the bottom-up influence on central processes as well as the use of one modality to strengthen another. They showed that low-level temporal asymmetries are related to asymmetries in linguistic processing using the Fused Dichotic Words Test and the Visual Inspection-time test. Spinelli and Mecacci (1990) provided information linking hemispheric asymmetry and pattern reversal visual-evoked potentials. They reported that eye dominance appeared to play a role in determining hemispheric asymmetry. Dalton, et al (1992) presented preliminary electrophysiological data on a population of children with LD plus ADHD, CAPD, dyslexia, and autism. Findings revealed abnormal auditory brainstem evoked responses (BSER) to a unique dichotic stimulus called Virtual Image Analysis (VIA) (Dalton and Cooper, 1985, United States Patent #4,5560601985) expanded the clinically established brainstem evoked response paradigm by adding a third dimension to the results. With standard BSER the results depend on the amplitude and latency of a series of waves evoked by a unilateral auditory click. In dichotic evoked BSER (VIA) the stimulus consists of two identical BSER clicks (Dalton, et al, 1985) manipulated in the time domain so that precise time/phase changes challenge the dichotic interaction of the auditory system. The results show a relationship between the wave latencies and amplitude to the lead/lag of the VIA dichotic stimulus.
Auditory Intensity Calibration
There are several reasons for careful control of the auditory output of the CD ROM. One obvious reason has to do with listener comparison (inter and intra). A basic rule of data collection should always be consistency of stimulus parameters. A second more exotic problem relates to over-amplification that may cause discrimination "rollover." Rollover is seen in retrocochlear and/or central hearing problems and is manifested as a reduction in word discrimination ability as intensity is increased (Jerger & Hayes, 1977). Spatial and Temporal Summation, as previously discussed, are not bilaterally equal. The auditory pathway consists of many areas that have unique chores some dealing with loudness, others time or phase, while others look for specific frequencies all to be integrated at the central level into meaningful symbols of language. Since loss of word discrimination (intrinsic and extrinsic) is an integral part of central language dysfunction it is imperative to reduce any element that might add to the loss. Calibration assures inter-subject stimulus accuracy while at the same time reduces the possibility that rollover may be a factor in inter-session accuracy for a single participant. Dichonics provides two calibration options: I. Biologic: sets the loudness (a subjective human judgment) to a comfortable level for a "normal" listener and II. Electroacoustic: sets the intensity objective relating to a physical measure of volts or sound pressure level (SPL).
Biological Calibration (BC): The default option is called biological because the loudness (as opposed to intensity) is subjectively judged to be at a comfortable level by a person with normal hearing. The BC can also be done using several listeners with the final calibration being a best fit of those listeners. BC is satisfactory for home use and individual use in schools where multiple computers might be used. This calibration level is then stored within the program and automatically sets the soundcard at that level every time the program is loaded. Hence, intersession or intersubject stimulation loudness remains constant.
Electronic Calibration Meter (Electroacoustic): When data are to be compared in any way, such as with a control group, or to a "normal" population, then the second calibration method, is advised. Here an electronic comparator (Dalton & French, 2002), set to a fixed intensity, automatically adjusts the soundcard of any computer to a known, and constant, stimulus level delivered to the earphones. A single calibration tone (1kHz) is delivered via the PC soundcard to the meter that compares the intensity of the soundcard output to a known voltage in the meter. When the two voltages are equal the calibration level is stored within the program and automatically sets the soundcard at that level every time the program is loaded. (3)
The Speech Stimulus
The speech stimuli in Dichonics are never changed as to loudness or structure of the basic stimulus. Any modification is caused by changing the relationship of one ear over the other or by masking the constant stimulus. Therefore, the live speech recorded on the CD-ROM is constant in production and loudness. A female speaker of General American English with a contralto voice delivered live speech via microphone directly into speech processing software contained within the computer. The initial readings were monitored by a volume units (VU) meter and later normalized to be within a set range of loudness prior to calibration. Masking noises were spectrographically selected as pink, brown and white noise. All intensity levels were under computer control.
The VIA is a non-speech stimulus. It too, is set at a fixed intensity that remains unchanged throughout. The only changing parameter is the time of arrival of each stimulus to the ears.
Most educational/therapeutic programs measure progress using pre/post testing that do not account for other uncontrolled influences such as readiness, supplemental training and, other intervening educational or non-educational factors. Operant conditioning measures the immediate present-response to a stimulus and compares it to the immediate-past response. A cumulative recording plots progress according to quickness and correctness (rate and accuracy) of the response. The building of a baseline depends on "shaping" incorrect or random behaviors into the desired and well-defined immediate acquisition curves reflected by the cumulative recording (baseline) all the while providing reinforcement for "correct" responses and repeat stimulation for incorrect responses.
The design of an instrumental conditioning program must carefully consider the nature and role of the two major components--stimulus and response (S-R). Learning has not necessarily taken place when the startle reflex is triggered in a newborn to a loud sound. However, when the child begins to look toward that sound then learning has commenced. Later, the child can be taught to raise a hand in the presence of that same loud sound. Here the simple sound/response relationship ends. To proceed beyond this normally, cognition must convert complex sensory information into learned behavior. For this to happen, the individuals must have a viable peripheral sensory system (hearing, vision, touch, smell), an intact neurological system (cranial nerves, brainstem, etc.) to transmit, receive and process the external stimuli, and cognitive power to convert the neural information into meaning leading to a decision followed by an appropriate response. Whether all of these involved steps are occurring is revealed by baseline acquisition.
Therefore, five necessary components of the S-R design must be considered, including (1) the cognitive level of the participant (entering behavior), (2) the sensory integrity of the participant, (3) the nature of the stimulus, (4) the method of the stimulus delivery, and (5) the method of responding. These five components are inextricability entwined but can be individually modified to allow progress in other areas. Figure one shows the flow chart of the Dichonics program.
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The program automatically determines the route to be followed using progress information provided by baseline acquisition. It is the role of the therapist to carry out any shaping necessary to develop usage of the mouse or keyboard. The producers of the Dichonics program have also developed a series of companion CD-ROM therapies that are specifically designed for special functions. For example, a mouse-usage shaping program that is particularly useful with students who have autism begins with the presentation of a single door on the computer screen. The mouse must be positioned on the door and left there for the door to open in order for an animation to appear. The door then closes automatically, after which the mouse must be removed so that the task can be repeated. No "mouse clicks" are required at this stage. The program then progresses to two doors and then four doors until finally the left button of the mouse must be clicked to manually cause the doors to open. The pictures behind the doors begin with animals making their unique sounds. The students usually produce the sounds without prompting. Two critical problems can occur, including superstitious behavior and perseveration. These must be carefully shaped-out by the therapist (Dalton, 1969). An example of superstitious behavior was observed in the case of a student with autism. This student circled the screen with the mouse before placing it on the door. Perseveration occurs when a student follows the exact pattern on every attempt to the extent that the introduction of new material becomes impossible.
Table 1 (below) shows the results from the Probe section of Dichonics for a single school population of students who had been qualified for language therapy by an SLP. Of the 21 students, 16 were right handed (RH), four were left handed (LH), and one showed no dominance preference. Of the 16 RH students, nine yielded right dominant VIA scores. All of the LH students scored right dominant VIA scores. Two students (LB & BG, both RH) scored 100% on Word Discrimination (WD) and Phonemic Inventory (PI). LB scored high normal on MEM, and BG scored low normal.
Fig 2 shows the baseline (BL) acquisition curve for the Table 1 population. The horizontal line in the Response Time panel is the mean response for students LB and BG.
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Figure 3 is a screen shot (4) of the progress display for a "typical" student. Note that this student has received three awards and has 20 points toward another. The SLP in this situation has a "Store" where the certificates could be used as money to buy any number of items from toys to school supplies.
Student EY is a 9 year old diagnosed (5) with autism. His shaping occurred over a four-week period with three attempts at introduction before BL began to take hold. Figure 4 reveals severe phonemic problems. He scored 100% on phonemes occurring at the beginning of words and recognized none in the final position. Some progress began to show with the middle position being at 100% for the forth set of trials. The Response time was slow but within tolerance range. Figure 5 is BL progress for EY.
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Figures 6, 7 and 8 show Dichonics data for Ashtin, a 6th grader, who had been qualified for language therapy with a diagnosis of Apraxia.
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Ashtin is an outgoing young lady who loves therapy. Her language skills belie her therapy data. She has progressed only to lesson two (all short vowels plus /p/ and /b/) at the 80% accuracy level. Her responses are erratic in all regards except for response time on Phonemic Memory. Phoneme Inventory shows no systematic understanding of initial, medial or final positioning. Figure 9 is a sample of Ashton's writing.
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Because of the failure to adapt to the BL activity, Ashtin was placed on the Dichonics Language Explorer Series, Nouns K-2nd Grade, and the Dichonics auditory-visual articulation (AVA) program. AVA uses real-time spectrographic analysis that allows the student to compare his/her sound production intra or inter subject. In Ashtin's case, a side-by-side classmate was used for comparison of production. Also,
Ashtin wrote out every auditory stimulus or production. Ashtin's experience is an example of how some programs seem to not work as designed. However, the BL paradigm in Dichonics does reveal hard data points of entry into future therapy and does, as suggested, provide a descriptive diagnosis that helps define a complex child.
Dichonics has its drawbacks particularly in the educational environment. First, educators prefer numbers that can be plugged into a formula that yields a range of data compared to a normal population. Dichonics is not normed for that purpose. Second, in IEP language, it is difficult to make a statement as to where a student is going to be at any given point in the future (e.g., Jane will be at lesson 3 by Christmas) since the Dichonics data are generated, not subjectively determined. Third, some therapists and parents are impatient. They want a quick fix or the promise of one; and they are unwilling to take part in the shaping process. A forth drawback is that Dichonics breaks with tradition; and, like any such program, it is viewed with skepticism. Finally, Dichonics is based on behavioral principles and it is subject to the fallout from the "behavioral controls" bad rap of several years ago.
Dichonics is now under major revision. The first change is to address the more recent strong evidence that auditory problems are a factor of temporality. While the O-G therapy will continue as the template, the major emphasis will be on the "optimal listening condition" (OCD) rather than simple recognition. Extensive dichotic positioning will find BL for various temporal conditions and drill will look for BL improvement using the "best condition" performance.
A second major modification in Dichonics has to do with the continued rapid change in software development platforms. The predecessor to Dichonics (Dalton and Cooper, 1973) was written in DOS 2; subsequent versions were written in every Windows version produced from that basic platform. Because of the extensive automation of the Dichonics program, small changes in Windows mean severe changes in Dichonics. The original goal of Dichonics was to turn all (or at least most) of the decision processes over to the computer leaving the details as to when to move-on as a program function. The revised program will advise the user when to make changes but will not make them automatically. This has advantages in that it will allow far more options to be employed branching out to other specific drill not provided on the current disc.
Boehm, J.A. & Dalton, L.W. (1972) Electronic design of a test device to implement the MAID stimulus. Journal of the Acoustical Society of America, 51, 816-19.
Dalton, L.W. & French, B. (2002) Calibration and security device for PC auditory programs. United States Patent # 6,654,652.
Dalton, L.W. and Kolosseus, J.E. (1996) Multi-channel brain mapping to a unique auditory stimulus. American Auditory Society, Salt Lake City, UT
Dalton, L.W. & Kolosseus, J.E. (1995) BAER latency delays dependency to a non-speech dichotic stimulus. American Auditory Society. Dallas, TX
Dalton, L.W., McKenzie, R.A, Kolosseus, J. E. & Barry, B. (1992) screening for central auditory dysfunction. Joint Session of Otolaryngology and Pediatrics, Southern Medical Association Scientific Conference, San Antonio, TX
Dalton, L.W. & Kolosseus, J.E. (1991) Dichotic auditory virtual image analysis: a non-linguistic central processing test. International Symposium on Screening Children for Auditory Function. Vanderbilt University, Nashville, TN
Dalton, L.W. & Kolosseus, J.E. (1986) Cerebral dominance and dichotic listening. Pediatric Audiology Up-date, Newport RI
Dalton, L.W. & Cooper, W.C. (1985) Method and apparatus for measuring differential auditory system, United States Patent #4,556060
Dalton, L.W. & Kolosseus, J.E. (1982) Virtual image perception as a technique for early identification of learning disabilities. AACLD-CE Conference, Albuquerque, NM
Dalton, L.W. & Kolosseus, J.E. (1981) The virtual image analysis (VIA) as a technique for measuring dyslexia. The American Speech & Hearing Association, Colorado Springs, CO.
Dalton, L.W. (1979) Listening preference in the rhesus monkey. The American Speech & Hearing Association, Atlanta, GA
Dalton, L.W. & Cooper, W.C. (1973) Phonemic Gobble. Copyright 1973.
Dalton, L.W. An operant procedure for neonatal hearing testing. The American Speech & Hearing Association, Chicago, IL, November 1971.
Dalton, L.W. & Allen, J.A. (1969) A VI schedule for stimulus presentation in evoked response audiometry for monkeys. The American Speech & Hearing Association, Chicago, IL
Dalton, L.W., Allen, J.A., Henton, W. & Taylor, H. (1969) Auditory thresholds is the rhesus monkey using a closed system helmet. Journal of Auditory Research. 9,178
Dalton, L.W. (1967) Operant conditioning as reflected in the conditioned suppression paradigm; a primate-working model. Scientific Exhibit, The American Speech & Hearing Association, Chicago, IL
Elias, L.J., Bulman-Fleming, M.B. & McManus, I.C. (1999). Visual temporal asymmetries are related to asymmetries in linguistic perception. Neuropsychologia. 37, 1243-9.
Green, V.A., Pituch K.A., Itchon, J., Choi, A., O'reilly, M. & Sigafoos, J. (2005) Internet survey of treatments used by parents of children with autism. Research in Developmental Disabilities.
Guyer, B.P. & Sabatino, D. (1989) The effectiveness of a multisensory alphabetic phonetic approach with college students who are learning disabled. Journal of Learning Disabilities. Aug-Sep; 22(7): 430-4.
Higgins, E.L. & Raskind, M.H. (2004) Speech recognition-based and automaticity programs to help students with severe reading and spelling problems. Annals of Dyslexia. Dec; 54(2): 365-92.
Jerger, J. & Hayes, D. (1977) Diagnostic speech audiometry. Arch chives of Otolaryngology. Apr; 103(4): 216-22
Levy, S.E. & Hyman S.L. (2005) Novel treatments for autistic spectrum disorders. Mental Retardation and Developmental Disabilities Research Review. 11(2): 131-42
Liegeois-Chauvel, C., de Graaf, J.B., Laguitton, V. & Chauvel, P. (1999) Specialization of left auditory cortex for speech perception in man depends on temporal coding. Cerebral Cortex. Jul-Aug; 9(5): 484-96.
Lilienfeld, S.O. (2005) Scientifically unsupported and supported interventions for childhood psychopathology: a summary. Pediatrics. Mar; 115(3): 761-4.
Oakland, T., Black, J.L, Stanford, G., Nussbaum, N.L. & Balise, R.R. (1998) An evaluation of the dyslexia training program: a multisensory method for promoting reading in students with reading disabilities. Journal of Learning Disabilities. Mar-Apr; 31(2): 140-7.
Oates, R.D. (1998). Frontal, temporal and liberalized brain function in children with attention-deficit hyperactivity disorder; a psychophysiological and neuropsychological viewpoint on development. Behavioral Brain Research. 94, 83-95.
Orton, J.L. (1965) A guide to teaching phonics. Educators Publishing Service, 75 Moulton St., Cambridge, MA
Skinner, B. F. (1938) The behavior of organisms. Annals of experimental analysis of behavior, New York, Appleton Century Crofts.
Stecker, G.C. & Hafter, E.R. (2000). An effect of temporal asymmetry on loudness. Journal of Acoustical Society of America. 107, 3358-68.
Spinelli, D. & Mecacci, L. (1999). Handedness and hemispheric asymmetry of pattern reversal visual-evoked potentials. Brain and Cognition. 13, 193-201.
Tallal, P., Merzenich, M., Miller, S. & Jenkins, W. (1998) Language learning impairment: integrating research and remediation. Scandanavian Journal of Psychology. Sep; 39(3): 197-9.
Tallal, P. & Stark, R.E. (1981) Speech acoustic -cue discrimination abilities of normally developing and language-impaired children. Journal of the Acoustical Society of America. Feb; 69(2): 568-74.
Wray, J, Silove N, & Knott H. (2005) Language disorders and autism. Medical Journal of Australia. Apr 4; 182(7): 354-60.
(1) Spatial and temporal summation is a cross-modality phenomenon and is not particularly intensity sensitive. When two or more subthreshold stimuli of differing modalities are applied simultaneously, or within a short period, a neural response may occur. This information was available at the time Orton (1936) was introducing his multimodality therapy concept. A paper focusing on modality interaction (Dalton, in prep) will look at stimulus effects on clinical electrophysiological responses in LD children and the possible implications in comorbidity theory.
(2) This relationship appears to change when measuring the stimulus effects electrophysiologically. In a behavioral response the Ss will point to the left side of midline when evoked potentials reveal more robust right activity. This would tend to confirm dominance for auditory processing (Dalton, et al, 1992).
(3) Matched sets of earphones and the comparator were offered with the first issue of Dichonics and, unfortunately, most potential users rejected the need for such specific calibration. Even the necessity of matched earphones was ignored; some used speakers and complained that the program was not working.
(4) A screen shot is an actual pictorial of the computer display representing stored data on the hard drive. A computer generated graphic from actual data collected from the therapy process
(5) The term "diagnosis" is used here to express an existing condition determined by a licensed or certified specialist other than this writer or the SLP providing services. The student was qualified for therapy by an IEP committee including an SLP and educational psychologist.
Author contact information:
Leslie Dalton, Ph.D., CCC-SLP/A
RR 1, Box 537
Ava, MO 65608
Leslie Dalton, Ph.D., CCC-SLP/ABA President and CEO of Sonido Educational Software Products. Retired Professor, Valdosta State University, Valdosta, Georgia
Table 1. Sample Data Word Phonemic Discrimination Inventory Participant Hand VIA Mem D R L I M F AD R 2 3 100 100 100 80 70 100 B L -2 3 100 96 88 100 100 100 BG R 2 4 100 100 100 100 100 100 BS R 1 3 70 56 70 84 78 86 DT L -2 2 100 80 95 100 62 75 HG L -2 3 95 85 81 100 100 100 JF R 1 3 100 100 100 100 55 65 JH ? 0 3 100 100 82 100 80 100 JI R -4 3 100 97 97 90 100 100 JI R -1 4 60 80 80 100 70 85 JJS R -4 3 100 97 83 100 60 98 LB R 2 6 100 100 100 100 100 100 LC R -2 4 100 84 84 100 73 75 LW L -4 3 100 95 60 60 83 100 ML R -2 5 100 100 100 80 76 100 MM R -4 4 84 100 100 82 64 82 MR R -2 2 100 100 100 90 100 100 SD R -2 3 100 100 100 100 62 64 SM R -2 3 60 80 80 100 88 64 ST R 0 3 100 100 100 100 50 100 TW R 4 4 100 84 100 70 38 48
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|Publication:||The Journal of Speech-Language Pathology and Applied Behavior Analysis|
|Date:||Jan 1, 2006|
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