Department of Communication Sciences and Disorders, Syracuse University, NY.
Lang Speech Hear Serv Sch. 2019 Jul 12;50(3):343-355. doi: 10.1044/2018_LSHSS-18-0081. Epub 2019 May 3.
Purpose Operationalized treatments for school-age children with speech sound disorders may result in more replicable and evidence-based interventions. This tutorial describes Speech Motor Chaining (SMC) procedures, which are designed to build complex speech around core movements by incorporating several principles of motor learning. The procedures systematically manipulate factors such as feedback type and frequency, practice variability, and stimulus complexity based on the child's performance. Method The rationale and procedures for SMC are described. Examples are presented of how to design stimuli, deliver feedback, and adapt the approach. Free resources are provided to guide clinicians through implementation of the procedure. Data on fidelity of implementation and dose per session are presented. Clinical and research evidence is provided to illustrate likely outcomes with the procedure. Results SMC is a method that can result in successful acquisition of target speech patterns and generalization to untrained words. Most clinicians can implement the procedure with over 90% fidelity, and most children can achieve over 200 trials per session. Conclusion Clinicians and researchers can use or adapt the operationally defined SMC procedures to incorporate several principles of motor learning into treatment for school-age children with speech sound disorders. Supplemental Material https://osf.io/5jmf9/.
针对学龄期言语障碍儿童实施操作性治疗，可能会产生更具可重复性和循证依据的干预措施。本教程介绍了言语运动连锁（SMC）程序，旨在通过整合运动学习的几个原则，围绕核心运动构建复杂的言语。这些程序会根据儿童的表现，系统地操作反馈类型和频率、练习变异性和刺激复杂性等因素。
描述了 SMC 的基本原理和程序。展示了如何设计刺激物、提供反馈以及调整方法的示例。提供了免费资源以指导临床医生实施该程序。呈现了关于实施保真度和每次治疗剂量的数据。提供了临床和研究证据来说明该程序的可能效果。
SMC 是一种可以成功习得目标言语模式并推广到未训练单词的方法。大多数临床医生可以以超过 90%的保真度实施该程序，大多数儿童可以在每次治疗中完成超过 200 次尝试。
临床医生和研究人员可以使用或改编操作性定义的 SMC 程序，将运动学习的几个原则纳入到针对学龄期言语障碍儿童的治疗中。
