Therapy for Individual Phonemes Flashcards
I. TEACHING /K/ AND /G/**
- The dorsum of the tongue must raise to contact the soft palate and form a seal which completely blocks the air stream
- The back of the tongue must suddenly pull away from the velum to create a ________ of air
Strategies for eliciting these phonemes:
if ch ________, hold down tongue tip
place your fingers under ch’s ______, push up
tell the child to hold his tongue against his lower teeth and hold his hand in front of his mouth to feel the burst of air as he imitates you - tell him to raise the back of his tongue
- Use a mirror, and have the client __________ you
- Use a tongue ___________ to push the tongue upward and backward in the oral cavity
say /iiiiiiii/, raise tongue to contact soft palate, make burst of air
shape /k,g/ from prolonged /ng/
- Hold a piece of tissue, paper, or a feather in front of your mouth to demo ___________.**
- Marshmallow crème on Ch’s soft palate–get crème with middle of her tongue
I. TEACHING /K/ AND /G/**
- The dorsum of the tongue must raise to contact the soft palate and form a seal which completely blocks the air stream
- The back of the tongue must suddenly pull away from the velum to create a burst of air
Strategies for eliciting these phonemes:
if ch fronts, hold down tongue tip
place your fingers under ch’s chin, push up
tell the child to hold his tongue against his lower teeth and hold his hand in front of his mouth to feel the burst of air as he imitates you - tell him to raise the back of his tongue
- Use a mirror, and have the client imitate you
- Use a tongue depressor to push the tongue upward and backward in the oral cavity
say /iiiiiiii/, raise tongue to contact soft palate, make burst of air
shape /k,g/ from prolonged /ng/
- Hold a piece of tissue, paper, or a feather in front of your mouth to demo aspiration.**
- Marshmallow crème on Ch’s soft palate–get crème with middle of her tongue
Teaching /s/ and /z/
can refer to these sounds as __________ analogies
Shape /s/ from words that end in /ts/ (like “boats” or “cats”)**
- Tell Ch to _______ her tongue after she says /t/
- Try having the child strongly aspirate /t/ ►German affricate /ts/. Have the child _________ second part of this affricate.
- And notice that when you make a really strong /t/, your tongue tip drops into perfect position for a predorsal /s/
- Tell the child that when her tongue drops down, hold it there and produce an /s/
other techniques for /s/
mirror
for a tongue-tip down /s/ tell client to position back/sides of tongue to _________ upper back teeth
place tongue tip behind lower __________ incisors
close teeth, initiate /s/
can draw /s/, trace /s/ in salt or sand, tactile cue (finger up arm)
Teaching /s/ and /z/
can refer to these sounds as animal analogies
Shape /s/ from words that end in /ts/ (like “boats” or “cats”)**
- Tell Ch to drop her tongue after she says /t/
- Try having the child strongly aspirate /t/ ►German affricate /ts/. Have the child prolong second part of this affricate.
- And notice that when you make a really strong /t/, your tongue tip drops into perfect position for a predorsal /s/
- Tell the child that when her tongue drops down, hold it there and produce an /s/
other techniques for /s/
mirror
for a tongue-tip down /s/ tell client to position back/sides of tongue to contact upper back teeth
place tongue tip behind lower central incisors
close teeth, initiate /s/
can draw /s/, trace /s/ in salt or sand, tactile cue (finger up arm)
To develop a central airstream:
close teeth, direct airstream through a straw
place finger at very center of teeth, attempt /s/
draw a small target, hold it in front of ch’s mouth, tell her to make a bull’s-eye with the /s/
types of lisps
type 1: the _________ lisp
teeth not __________, tongue tip typically near or _________ lower central incisors
tongue not between teeth
ch may have _______ bite
type 2: the __________ lisp
tongue tip ____________ between upper and lower central incisors
mr. mouth is helpful
type 3: the __________ lisp
tongue tip touching __________ ridge
air forced laterally, creating significantly distorted friction
very hard to fix
- Have the child strongly aspirate a /__/
- Use a ______ ________ to stabilize production
- This helps the jaw to not move around
- Have the child say /t t t t t t ssssss/
- Eventually you can get away from the bite block
types of lisps
type 1: the frontal lisp
teeth not together, tongue tip typically near or behind lower central incisors
tongue not between teeth
ch may have open bite
type 2: the interdental lisp
tongue tip protruded between upper and lower central incisors
mr. mouth is helpful
type 3: the lateral lisp
tongue tip touching alveolar ridge
air forced laterally, creating significantly distorted friction
very hard to fix
- Have the child strongly aspirate a /t/
- Use a bite block to stabilize production
- This helps the jaw to not move around
- Have the child say /t t t t t t ssssss/
- Eventually you can get away from the bite block
III. TECHNIQUES FOR /l/**
- One of the most common errors in children is __/__ (“I yike that yamp.”). Gliding!!
- I like to tell kids about the “magic spot” (the alveolar ridge)
- It is very important for kids to have perfect ____________ of the _________ ________ and know exactly where their tongue is to be placed
use tongue deressor to physically touch alveolar ridge
use a mirror
use altoid, lifesaver, or fruit loop. tongue tip holds it on alveolar ridge for 5-10 seconds then they cat eat it. squish lifesaver between tongue tip and alveolar ridge. lick caramel off alveolar ridge, tongue clicks
be sure child is not rounding lips, heve her smile
Use the _________ technique
- Using /t, d, n/ as ____________ contexts
- E.g., ch can say na-la, na-la or da-la, da-la
III. TECHNIQUES FOR /l/**
- One of the most common errors in children is j/l (“I yike that yamp.”). Gliding!!
- I like to tell kids about the “magic spot” (the alveolar ridge)
- It is very important for kids to have perfect awareness of the alveolar ridge and know exactly where their tongue is to be placed
use tongue deressor to physically touch alveolar ridge
use a mirror
use altoid, lifesaver, or fruit loop. tongue tip holds it on alveolar ridge for 5-10 seconds then they cat eat it. squish lifesaver between tongue tip and alveolar ridge. lick caramel off alveolar ridge, tongue clicks
be sure child is not rounding lips, heve her smile
Use the ribbon technique
- Using /t, d, n/ as coarticulatory contexts
- E.g., ch can say na-la, na-la or da-la, da-la
IV. TECHNIQUES FOR /θ/**
•One of the most common errors is f/θ
To teach /th/ production:
mirror
mr. mouth
tell ch to open teeth slightly
tongue tip must __________ between upper and lower cenetral incisors
I have found that…**
- Many adult _________ _________ are not comfortable with their tongue protruding
- They feel like the whole world is staring at them
- I do a lot of _____________ and do the exercises in the mirror along with them
- The mirror is super helpful, because they can see that they do not look like _______
If the client sticks her tongue out too far…**
•Hold a tongue depressor about ¼” in front of her teeth
if she can feel the tongue depressor when she produces /th/, her tongue is coming out too far
/θ/ can be shaped from several phonemes:**
- /__/ technique—have client prolong /__/, slowly stick her tongue out while gradually closing her mouth
- Good: /θ/ and /h/ are both voiceless fricatives
To direct airflow through the oral cavity:**
- Place straw where tongue tip contacts upper and lower front teeth, have client direct air into straw
- Put client’s finger in front of his lips, have him repeat procedure by himself
- Hold a strip of paper in front of client’s mouth, near tongue tip, ask him to blow out air to make paper move
IV. TECHNIQUES FOR /θ/**
•One of the most common errors is f/θ
To teach /th/ production:
mirror
mr. mouth
tell ch to open teeth slightly
tongue tip must protrude between upper and lower cenetral incisors
I have found that…**
- Many adult accent clients are not comfortable with their tongue protruding
- They feel like the whole world is staring at them
- I do a lot of desensitization and do the exercises in the mirror along with them
- The mirror is super helpful, because they can see that they do not look like idiots
If the client sticks her tongue out too far…**
•Hold a tongue depressor about ¼” in front of her teeth
if she can feel the tongue depressor when she produces /th/, her tongue is coming out too far
/θ/ can be shaped from several phonemes:**
- /h/ technique—have client prolong /h/, slowly stick her tongue out while gradually closing her mouth
- Good: /θ/ and /h/ are both voiceless fricatives
To direct airflow through the oral cavity:**
- Place straw where tongue tip contacts upper and lower front teeth, have client direct air into straw
- Put client’s finger in front of his lips, have him repeat procedure by himself
- Hold a strip of paper in front of client’s mouth, near tongue tip, ask him to blow out air to make paper move
Tx for /r/ - A. INTRODUCTION—ORAL MOTOR EXERCISES**
- Remediating /r/ is one of the most frustrating jobs that SLPs have
- It is a very complex sound that requires __________ and muscle strength
- The use of oral motor techniques for helping clients with /r/ problems is hotly debated
- Some say that there is no research to support the efficacy of oral motor exercises—this is true
However…**
- Clinically, I and many of my friends in the profession have found them to be extremely beneficial
- I have a hypothesis that because so many children were ________ fed and/or used __________, tongue strength did not develop adequately
- Remember, for a baby, nursing requires far more work than drinking from a bottle!
Tx for /r/ - A. INTRODUCTION—ORAL MOTOR EXERCISES**
- Remediating /r/ is one of the most frustrating jobs that SLPs have
- It is a very complex sound that requires precision and muscle strength
- The use of oral motor techniques for helping clients with /r/ problems is hotly debated
- Some say that there is no research to support the efficacy of oral motor exercises—this is true
However…**
- Clinically, I and many of my friends in the profession have found them to be extremely beneficial
- I have a hypothesis that because so many children were bottle fed and/or used pacifiers, tongue strength did not develop adequately
- Remember, for a baby, nursing requires far more work than drinking from a bottle!
There are many oral motor exercises - /r/
lift middle and back of tongue to hard palate, hold it, press hard
client pushes tongue forward, presses against tongue depressor
- Put cake sprinkle at corner of Ch’s mouth, have her move her tongue laterally to get it
- Ch can stick her tongue forward and lick cake gel off of a tongue depressor
- Squeeze soft cheese or frosting on her hard palate, have her lick it off
- Tells parents of /r/ kids that all liquids have to be drunk through a _______—beginning today!
- NO MORE ________ ________
- Tells parents of /r/ kids that all liquids have to be drunk through a straw—beginning today!
- NO MORE SIPPY CUPS
/r/ - Have the client practice
•/__-__-__-__-__/ as fast as possible
Then, prolong /__/ (/g/ works too)
•Use /ng/–e.g. “thinggggrace”or “thingggrock”
/r/ - Have the client practice
•/k-k-k-k-k/ as fast as possible
Then, prolong /k/ (/g/ works too)
•Use /ng/–e.g. “thinggggrace”or “thingggrock”
B. /r/ WITH SMALL CHILDREN**
- Hodson believes that we can begin working on /r/ when children are as young as __ or __
- With these little ones, we don’t drill to __________ —but we “get it on their radar”
How do we do this with young kids?**
- I like to get them a stuffed tiger and talk about the growling tiger sound
- I ask the family to put the tiger in a prominent spot and talk about the /r/ regularly
For example, when they are reading books with their children…**
- Point out /r/
- “Oh, there is your special tiger sound!”
- I ask parents to ________ correct /r/ productions regularly
- BUT…do not push the child too hard to produce it
B. /r/ WITH SMALL CHILDREN**
- Hodson believes that we can begin working on /r/ when children are as young as 3 or 4
- With these little ones, we don’t drill to precision —but we “get it on their radar”
How do we do this with young kids?**
- I like to get them a stuffed tiger and talk about the growling tiger sound
- I ask the family to put the tiger in a prominent spot and talk about the /r/ regularly
For example, when they are reading books with their children…**
- Point out /r/
- “Oh, there is your special tiger sound!”
- I ask parents to model correct /r/ productions regularly
- BUT…do not push the child too hard to produce it
C. SPECIFIC TECHNIQUES for /r/
2 ways for /r/ - ___________ and _________ position
retroflexed is easier to ________, bunched is easier in connected _________
mr. mouth is helpful. child show you preference
It is best to start each session with __________ ___________
use +__dB than reguar speech
also beneficial to link /r/ to _________
_____________ awareness activities (rhyming, round, blending, etc)
writing, coloring
C. SPECIFIC TECHNIQUES for /r/
2 ways for /r/ - retroflexed and bunched position
retroflexed is easier to teach, bunched is easier in connected speech
mr. mouth is helpful. child show you preference
It is best to start each session with auditory bombardment
use +20dB than reguar speech
also beneficial to link /r/ to print
metaphonological awareness activities (rhyming, round, blending, etc)
writing, coloring
Ann Tyler 2015
Very important to implement ___ for all work on phonemes
tx idea: draw a soup bowl, make postits with 15 /r/ words in initial, medial, and final position
figure out words that rhyme with those in the soup bowl
do sound ___________“r-a-k-e” which one am i talking about?
Ann Tyler 2015
Very important to implement PA for all work on phonemes
tx idea: draw a soup bowl, make postits with 15 /r/ words in initial, medial, and final position
figure out words that rhyme with those in the soup bowl
do sound blending“r-a-k-e” which one am i talking about?
/r/ - We can use classroom textbooks for ____________ awareness…Helps us link with ___________
We need to be sure…**
- Children are sitting up straight with their feet on the floor
- Their bodies need to be stable
Very important to teach __________ /r/ before ___________ /r/
start with /ar/, /gr/, etc before blends
best to have ch repeat /r/ many times, don’t jump to consonantal /r/ too quickly
after drilling /r/ for a few weeks, can go to consonant + /r/
avoid words that contain both /r/ and /__/
/r/ - We can use classroom textbooks for metaphonological awareness…Helps us link with curriculum
We need to be sure…**
- Children are sitting up straight with their feet on the floor
- Their bodies need to be stable
Very important to teach vocalic /r/ before consonantal /r/
start with /ar/, /gr/, etc before blends
best to have ch repeat /r/ many times, don’t jump to consonantal /r/ too quickly
after drilling /r/ for a few weeks, can go to consonant + /r/
avoid words that contain both /r/ and /w/
- I like shaping /r/ from /i/–”eeeeeeeerrrr”**
- Helpful to smile; can’t make a /w/
- **A great technique is from _________—the SLP puts her fist under the client’s chin and pushes upward—this elevates the tongue
- We can use a tongue depressor to push the client’s tongue back in her mouth
**The biggest thing with /r/…
- Is __________
- /r/ is hard; strong lingual muscles are needed
If the client doesn’t practice, no progress!
**Remember that the foundation of all articulation therapy is:
- ____________
- ____________ the muscles
- Lots of ____________
- I like shaping /r/ from /i/–”eeeeeeeerrrr”**
- Helpful to smile; can’t make a /w/
- **A great technique is from PROMPT—the SLP puts her fist under the client’s chin and pushes upward—this elevates the tongue
- We can use a tongue depressor to push the client’s tongue back in her mouth
**The biggest thing with /r/…
- Is PRACTICE
- /r/ is hard; strong lingual muscles are needed
If the client doesn’t practice, no progress!
**Remember that the foundation of all articulation therapy is:
- PRACTICE
- Retraining the muscles
- Lots of repetitions
