An easy onset refers to the light contact of the vocal folds during word production. The goal is to produce easy closure of the vocal folds via airflow to produce a vowel, instead of a hard closure (attack) to produce a burst of air through the vocal folds (Super Duper, 2011). This strategy is used to increase fluency in those individuals who have fluency disorders
Impairment: Hyperkinetic Dysarthria
Therapy Goal: In six months, with given direct instruction and modeling, the client will use easy onset when producing functional phrases in front of the clinician with 80% accuracy as measured by SLP data collection.
Activity Breakdown
A bag is filled with 25 house objects.
3. The clinician models functional short phrases using the onset before phonation. The clinician instructs the client to exhale slightly and say hhhhhhh before saying the first word in the phrase.
4. Clinician selects a carrier phrase that begins with a vowel, such as “I have a _____.” Have the client choose one object from a bag and use that item to complete the phrase (eg., I have a brush) and have the client repeat the carrier phrase 5 times using the easy onset strategy. When necessary the clinician will provide a model for the smooth, easy-speaking voice and ask the client to repeat after the clinician.
6. The sequence is repeated with another object.
Hierarchical Cueing
(most to least)
Modeling: The Clinician will read the functional phrase using the easy onset strategy.
Direct verbal prompt: The clinician will provide direct feedback to the client when the client uses a hard closure of the vocal folds.
Scaffolding with the use of non-verbal prompt: The clinician uses hand gestures to indicate easy onset before phonation.
Fade verbal prompt: The client is able to produce a functional phrase with the easy onset strategy with minimal to no verbal or non-verbal prompts.
25 household items
Bag
An Evidence-based Approach
Easy onset was "chosen because [it] requires [it] an open vocal fold posture and therefore inhibit the production of laryngeal blocks". "The use of easy onset is particularly appropriate because it tends to inhibit the production of word-initial disfluencies."
References
Dale, P. S., & Hayden, D. A. (2013). Treating speech subsystems in childhood apraxia of speech with tactual input: The prompt approach. American Journal of Speech-Language Pathology, 22(4), 382-404. https://doi.org/10.1044/1058-0360(2013/12-0055)
