Therapy for individual phonemes Flashcards
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 burst of air
strategies for eliciting these phonemes
- if ch. fronts, hold down tongue up
- place your fingers under ch chin, push up
strategies cont..
- tell ch 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 tongue depressor to push the tongue upward and backward in the oral cavity
cont.
hold a piece of tissue paper or a feather in front of your mouth to demo aspiration
-marshmallow crème on ch soft palate – get crème with middle of her tongue
say /iiiiii/
- raise tongue to contact soft palate, make burst of air
- shape /k,g/ from PROLONGED /ng/
teaching /s/ and /z/
like to refer to theses sound with animal analogies
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 an open bite
type 2. the interdental lisp
- tongue tip protrude BETWEEN upper and lower central INCISORS
- MR. MOUTH helpful
type 3: the lateral lisp
- tongue tip touching alveolar ridge
- air forced laterally, creating significantly distorted friction
- very hard to fix
however we can
- have the child strongly aspirate a /t/
- use a bite block to stabilize production
- a bite block helps the jaw to not move around
- have the child say /t t t t t t t sssssss/
- eventual you can get away from the bite block
/s/ /z/ strategies
- 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
try this yourself
- and notice that when you make a really strong /t/, your tongue tip drops into perfect position for predorsal /s/
- tell the child that when her tongue drops down, hold it there and produce an /s/
other techniques for /s/ include:
- mirror
- for 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, intiate /s/
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 chs mouth; tell her to make a bulls eye with the /s/
other techniques
- tell the child to make a smile and hide his tongue behind the white gate (teeth) while resting his tongue along his upper back teeth
- tell him to blow out a straight, fine stream of air
- place your finger in their center of his lips/teeth for an additional cue
Also
- draw /s/
- trace /s/ in salt or sand
- tactile cue (finger up arm )
techniques for /l/
- one of the most common errors in children is j/l ( I yike that yamp)
- I like to tell kids about the magic spot (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 mirror depressor to physically touch alveolar ridge
- mirror
One of my favorite techniques
-use altoid, lifesaver, or fruitless, tongue tip holds it on alveolar ridge for 5-10 seconds
be sure
- ch not rounding lips
- have her smile
other treatment ideas for /l/
- gummy life savers: try to squish life saver between tongue tip and alveolar ridge
- lick caramel off alveolar ridge
- tongue clicks
use the ribbon technique
- place a 1/2 ribbon across the front of the clients tongue so that the ends hang down to her chin
- then tell her to put her tongue tip on her alveolar ridge
- have her say /l/ while you gently pull down on the sides of the ribbon,which allows lateral airflow
i do like
- using /t,d,n/ as coarticulatory context
- e.g., ch can say na-la, na-la or da-la, da-la
techniques for th
- one of the very most common errors is f/th
- his SLP called “th” lip cooler
to teach /th/ production
- mirror
- mr.mouth
- tell child to open his teeth slightly
- tongue tip must protrude between upper and lower central incisors
i have found that
- many adult accent clients are not comfortable with their tongue protruding
- they feel like the while 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 an see that they do not look like idiots
if the client sticks her tongue out too far
- hold a tongue depressor about 1/4 in front of her teeth
- if she can feel the tongue depressor when she produces /t/ her tongue is coming out too far
/th/ can be shaped from several phonemes
- /h/ technique- have client protruding /h/ slowly stick her tongue out while gradually closing her mouth j
- good /th/ and /h/ are both voiceless fricative
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 clients finger in front of his lips have him repeat procedure by himself
- hold a strip of paper infront of clients mouth near tongue tip, ask him to blow out air to make paper move
oral motor exercises
- remediating /r/ is one of the most frustrating jobs that SLP have
- it is very complex sound that requres precision and MUSCLE STRENGTH
- the use of oral motor techniques for helping clients with /r/ probe 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 ch 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
- lift middle and back of tongue to hard palate, hold it press hard
- client pushes tongue forward presses against tongue depressor
other fun oral motor exercises
- put CAKE SPRINKLE at corner of ch mouth have her move her tongue LATERALLY to get it
- ch can stick her tongue forward and lick cake gell off a tongue depressor
- squeeze soft cheese or frosting on her hard palate haver her lick it off
one SLP i know
- tells all parents of her /r/ kids that all liquids have to be drunk through a straw
- no more sippy cups
- one child have pudding races with her lil bro
have client practice
/k-k-k-k-k-k/ as fast as possible
- then prolong /k/ /g/ works too
- use /ng/
/r/ with small ch
godson believes that we can begin working on /r/ when ch is as young as 3 or 4
-with little ones we DONT DRILL TO PRECISION but we get on with the radar
how do we do this with young kid?
- i like to get them a stuffed tiger and talk about the growling a tiger sound
- i ask the fam to put the tiger in a prominent spot and talk about the /r/ regularly
for ex: when they are reading books with their ch.
- point out /r/
- i ask parents to model correct /r/ productions regularly
- but do not push the child too hard to produce it
specific techniques
- 2 ways for /r/ RETROFLEX and BUNCHED position
- retroflex /r/ easier to teach, bunches /r/ easier in connected speech
- see what works for indie.
- mr. mouth helpful; ch show you preferred position
it is best to start each session
- with auditory bombardment
- use headphones at +20dB
- also beneficial to link /r/ to PRINT
- metaphonological awareness activities
- writing, coloring
ann tyler ASHA
- very important to implement phonological awareness for all work on phonemes
- TX idea: draw a soup bowl
tyler asha continue
- figure out words that rhyme with those in soup bowl
- do sound blending “r-a-ke” which one am i talking about?
we can use classroom textbooks for metaphonological awareness
help us link w classroom curiculum
we need to be sure
ch are sitting up straight with their feet on the floor
their bodies need to be stable
it is very important
- to teach VOCALIC /r/ before CONSONANTAL /r/
- start with /ar/ /er/ etc. before doing words like road, rat, ran
- save /r/ blends for later
best to
- best to have ch REPEAT “er” many times don’t jump to consonantal /r/ too quickly
- after drilling on ‘“er” for a few weeks c + er
- avoid words that contain both /r/ and /w/
- i like shaping /r/ from /i/
- helpful to smile ; can’t make a /w/
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
- repitions
