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This kind of verbal disapproval, when it reduces the production of wrong responses, is called corrective feedback or verbal punishment. Another important step the clinician takes is to systematically change the setting in which the treatment is carried out. In teaching this important skill, the clinician may begin by having the child evaluate his or her own productions as correct or incorrect. Teaching self-monitoring skills is perhaps one of the most significant strategies to promote long-term maintenance of what the clinician taches a child. Maintenance means the sustained production of clinically established skills over time and across situations. Generalization means the production of new skills in new environments without positive or corrective feedback. To encourage the child to produce the clinically established language skills in natural social contexts, the clinician implements additional procedures known as generalization and maintenance procedures. Unfortunately, the same children may be speechless in other situations, including their home and school. Under the controlled condition of the clinic and in the reassuring presence of the clinician, most children begin to produce what has been taught. Successful treatment of language disorders in children requires the cooperation of many individuals who normally interact with them. It is thought that making the final stages of the treatment situation resemble natural communicative exchanges promotes social communication skills. When the child learns to reliably produce a certain number of words, the clinician shifts training to two-word phrases and eventually to sentences and conversational speech. Target responses that are not imitated but produced in relation to more natural stimuli, such as a question or some event, are known as evoked responses. When the child begins to imitate the modeled response consistently on a certain number of trials, the clinician stops modeling. Punishment is a procedure designed to decrease the frequency of selected behaviors b arranging an immediate consequence for those behaviors, which may be as common a statement as "No" or "That's not correct". It was once thought that low intelligence might be a cause of speech sound production problems. A given opportunity to produce a correct target response also is called a trial. Many children with language disorders who cannot produce words or phrases can imitate when the clinician models them for imitation. After selecting the target behaviors, the clinician prepares a set of stimulus materials, which may be pictures, objects, or toys that help evoke the target responses from the child. Unless this complex stage of treatment is managed appropriately, the pragmatic production of language may not emerge. The language the child learns in the treatment sessions may or may not be produced in spontaneous conversational speech. After the child learns simple sentences, more complex sentences may be taught. Once the phrases are learned, the clinician targets simple sentences. The treatment for a child who has not learned words at all must be started at the word level. Functional language behaviors also are more likely to be produced at home and maintained over time. Therefore, teaching such functional targets will immediately improve the child's social communication. Language skills that are effective in social contexts are known as functional treatment targets. The functionality of specific language behavior is a major consideration in their selection. Even with extensive training, some children with language disorders may not achieve normal language functions. To the extent possible, the final treatment is normal conversation in every situation.
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