The ultimate goal of any skill area independent carryover and self-monitoring of skills across environments. A frequent challenge many speech therapists note is that a student may have a skill in the therapy room or in isolation but may not be able to apply that skill to other environments or contexts. Instructors should acknowledge and discuss factors that can impact generalization and self-monitoring with students to identify challenge areas and determine if those challenges can be monitored or overcome in any way.

• Perception: Deaf and Hoh students vary in how much sound access they have. Some can use the auditory feedback loop to self-monitor speech sound production. Co-occurring diagnoses impact perception as well, such as touch and vision senses.
• Environment: Communication environments vary greatly. There is a difference between a quiet structured therapy environment and spontaneous or natural communication scenarios. This is especially true for our Deaf and Hard-of-hearing students (Hoh) because background noise and reverberation can impact auditory monitoring of speech. Students may experience "listening fatigue" as well.
• Cognitive capacity: Self-monitoring and applying learned skills takes cognitive effort. A student's ability to do so may be impacted by their baseline executive functioning abilities. It may also be influenced by factors such as environment, fatigue, content of conversation, and emotional and physical state.
• Access to Tools: If shaping sounds and perception of sounds were taught via tools or strategies that aren't naturally occurring, the student may be less likely to monitor a specific goal skill outside of the therapy room. For example, spectrograms and mirrors are great tools to build perception and production in the therapy room but will likely not be present when a student uses spoken communication at a grocery store.
• Habit: Depending on the age of the student, they may need to retrain habituated motor plans. It may take some time and effort to teach the student to notice the errored or compensatory production in speech and replace it with the correct production.

When considering the "generalization phase" of therapy, imagine how skills will manifest or integrate into the student's natural environment. That should guide goal selection, scaffolded targets, and therapy environments. Approaches may include:

• Choosing relevant topics and therapy materials such as content from courses, relevant vocabulary from areas of interest, and practice interviews
• Using role play to practice skills in context and promote confidence
• Changing location of therapy sessions to expand the student's mental link of "making progress" within only one specific room/environment
• Have students practice with a new/unfamiliar listener
• Lead small group instruction for students with various goals to collectively apply learned skill in a low-risk environment with peers. Make a plan in advance for skills that will be practiced in group, or to review after the group meeting.