My client R. is currently six years, six months old. He has been diagnosed as having delayed speech and language. R. has been in therapy since he was first referred in preschool screening. In the past the clinician has worked on answering “wh” questions correctly and articulation errors, while I am currently working on auditory processing skills and articulation errors with him.
I have been seeing R. since the first week of clinic and his articulation errors have improved greatly. He has gone from working on the correct production of the /f/ phoneme in words to conversation. And we are currently working in the /s/, /r/ and voiced /th/ sounds in sentences.
The /r/ phoneme has been by far the hardest phoneme for R. to master. However, I have found a few techniques that are very helpful. R. substitutes /w/ for /r/ in the initial position of words and I have found that using a mirror to call attention to the puckered lips can be very affective. You ask the client to smile in an exaggerated manner, or inhibit the movement by pushing the upper lip back against the upper teeth with your thumb and forefinger.
Another technique I have used for the /r/ phoneme is to have the client imitate a rooster, siren, or growl like a bear. Also by placing your hand on the top of the child’s head and say, “Try to touch my hand with your tongue as you make the /r/ sound” can be very affective. Obviously, this is impossible to do, but most children get the idea.
Overall, I feel these techniques have been of great help to me, and I have seen a lot of improvement since R. has moved from the /r/ phoneme in the initial position of words to the initial position of words in sentences.
Reference:
Pendergast, K. (1971) Building Good Speech.111,112
3 comments:
I am also working on /r/ with a client, and I used the book that you mentioned by Kathleen Pendergast. I think it's a great book for placement cues, but I still needed some other ideas for my client. I found this article discussing how to use /i/ to elicit /r/. While that wasn't particularly useful for us, the use of the tongue blade definitely helped my client understand placement.
Wood, J.M. (1998). A clinical technique helpful in the elicitation of /r/ [Electronic version]. Language, Speech, and Hearing Services in Schools, 19, 96-99.
Emily also has some great links in her blog for /r/ techniques. Sounds like you're doing a great job. /r/ can be so frustrating for both us and the client!
Hey, I am working on the voiceless /th/ sound. I have also found that using the mirror really does help with having success in therapy. I have been looking around for information on articulation because I am not sure about you, but I always get tired of doing the same types of games and activites. One website that I use to help give me ideas sometimes is www.superduperinc.com. Anyways, keep up the good work and let me know if you ever come up with more interesting ways to work with artic. :)
Oh, I meant to tell you before and forgot. One of our textbooks we had in undergrad has a lot of helpful information about articulation. Jacqueline Bauman-Waengler has a text book called Articulatory and Phonological Impairments-A clinical focus: 2nd Edition. If you ever need to look up more information about artic. this book breaks it down. One chapter I like is on Therapy for Phonetic Errors.
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