DTTC Hierarchy Flow Chart
flow chart designed by Jennie Bjorem, M.A., CCC-SLP
www.bjoremspeech.com
Direct imitation: Eyes on me, say what I say", you model and the child imitates, listen
ctre
carefully for correct vowels within the production. Follow the flow chart. Our goal is
correct
or
inc
getting an accurate production consistently with the least amount of support.
Simultaneous production - the child will say the
correct
target with you at the same time. "watch me say it with Continue direct imitation - As long as
me". Provide all cueing necessary for the correct correct production continues, begin to
production. Stretch out sounds and slow rate if change prosody including stress and
t
ec
needed, change prosody but keep stress accurate.
orr
rate. Encourage the child to make the
inc
Continue with movement, don't segment. Don't expect target sound like your model.
the child to get the exact prosody as you in Establish multiple correct productions
incorrect
simultaneous production, but you should hear with good rate and varied prosody.
rect
variations in each trial. Begin slow and move to a
incor
t
normal rate.
c
rre
co
Delayed imitation - you provide a model
ct
Try taking away voicing and mime (move
re
and have the child pause... then imitate.
incor
your mouth) the target together working on Continue to work on correct productions
only the movement of the target without with prosodic variations in delayed
sound and then add back in the voice, using imitation. We are working on fading the
all of the cues to help the child produce the cues so the child can learn the new motor
corre
target correctly. Try again in simultaneous plan.
production.
ct
inc
orr
ect Continue practicing in delayed imitation and move to functional
spontaneous production. Try probing the target using questions or
in play. You may want to try adding the word to another core word.
Move to another target and For example if the child is able to say "Mama" and our target word
try this another session has been "hi" you would work on "hi mama" or "mama hi" usig the
same hierarchy flow chart. *Once the child consistently has the
target spontaneously it moves to our carryover practice list.
Strand, E.(2018) Childhood Apraxia of Speech Advanced Training Workshop. University of Kansas
Remember to be mindful of fading cues and circling back for more support when needed. Our goal is
accurate productions. Say to the child "you are a hard worker" and "when you work hard you learn hard
things" and "you should feel proud". Try to avoid "good job" or "you're so smart" or "I'm proud of you".
Encourage the drive and hard work to come from within. #wordpower #growthmindset
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Jennie Bjorem, M.A., CCC-SLP
DTTC Hierarchy Flow Chart
flow chart designed by Jennie Bjorem, M.A., CCC-SLP
www.bjoremspeech.com
Direct imitation -
"Eyes on me, say what I say", you say the target word/phrase and child imitates, listen
carefully for correct vowels within the production. Follow the flow chart. Our goal is getting an
accurate production consistently with the least amount of support.
incorrect correct
Simultaneous Production - the child will say the
target with you at the same time. "watch me say it
Continue direct imitation - As long
with me". Provide cueing necessary for the correct as correct production continues,
production. Stretch out sounds and slow rate if begin to change prosody including
needed. Avoid sounds you cannot stretch out such stress and rate. Encourage the child
as /p/ and /b/ if the child is having difficulty. incorrect to make the target sound like your
Continue with movement, don't segment. model.You can try different voices...
a mouse voice or a mad tone. Use
correct incorrect correct Bjorem Speech Prosody Cues.
incorrect
Establish multiple correct
As long as correct Try taking away voicing productions with good rate and
production continues, and mime (move your varied prosody.
begin to change prosody mouth) the target
incorrect correct
including stress and rate together working on only
and say the target the movement of the Delayed Imitation - you provide a
together. Don't expect the target without sound and model and have the child wait a few
child to get the exact seconds to say the target. Use a wait
then add back in the
prosody as you in visual if needed. Continue to get correct
voice, using all of the
simultaneous production, productions with different prosodic
cues to help the child variations in delayed imitation.
but you should hear produce the target
variations in each trial. correct
correctly.
Begin slow and move to a
normal rate. incorrect
Continue practicing in delayed imitation
You can say things like STOP and move to functional spontaneous
"When you watch me it will Move to another
help you".
target and try this
another session
use of the word. Try probing the target
using questions or in play. You may
correct incorrect want to try adding the word to another
core word. For example if the child is
Fade your voice, just mime the able to say "Mama" and our target word
movements while saying the target has been "hi" you would work on "hi
at the same time as the child having mama" or "mama hi" usig the same
the child say the target. You are hierarchy flow chart. *Once the child
correct giving less support to see if the child consistently has the target
spontaneously it moves to our
can obtain the movement.
carryover practice list.
Strand, E.(2018) Childhood Apraxia of Speech Advanced Training Workshop. University of Kansas
Remember to be mindful of fading cues and circling back for more support when needed. Our goal is
accurate productions. Say to the child "you are a hard worker" and "when you work hard you learn hard
things" and "you should feel proud". Try to avoid "good job" or "you're so smart" or "I'm proud of you".
Encourage the drive and hard work to come from within. #wordpower #growthmindset
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