January 12th, 2010
Problem: You are working with a child who is hard to understand because he speaks too quickly.
Generally, my focus will be on clarity rather than rate. I’ll say, “It is important that you say all your sounds when you speak.” Then, I’ll demonstrate clear speech and unclear speech. Often, the rate automatically reduces when the child focuses on clearly articulating all sounds.
If you feel focusing on rate is what you would like to do, you can give out “speeding tickets” when he speaks too quickly. His goal will be to not get more than x number of tickets in a session in order to get a sticker or candy treat.
Tags: articulation, speaking rate, speech problems, speech therapy
Posted in Fast talker, Speech Disorders, speech therapy | Comments Off
October 22nd, 2009
Problem: I have a student who is nearly 8 years old. This little boy stops all /s/, /sh/ and /s/ blends. He is able to produce the /s/ sound and is able to produce the sound in words when segmented from the vowel. However, whenever it gets close to a vowel, he inserts a /d/, i.e. sdo/so. He is able to produce /s/ blends in words in targeted structured tasks but I see little to no carryover. He can produce /s/ final in words with ease, but, again, has no transition to spontaneous speech. He also has no /r/or /r/ blends and when not in targeted tasks, can intermittently front /k/ and /g/.
I feel like I am at my wit’s end. I’m sure you get emails like this all the time, but I HAVE NO IDEA HOW TO STOP HIM FROM INJECTING THE D! If you have any suggestions, I will try anything. Thank you for any time or suggestions you are willing to offer.
An 8 year old child who’s still in speech poses problems to all of us. They are habituated to their errors and are very sensitive about changing their speech patterns. Among the children I’ve spoken to, most are concerned that the new way of saying the sound feels odd and they worry that they will sound strange to their friends if they change their pattern. Some don’t realize that they sound different than their peers. For these reasons I usually talk to children this age and older about how their new sound sounds to them, how they produce it that makes them sound different than their peers, and finally, how others will really think they sound when they produce the new sound in speech.
Regarding /k/ and /g/: Write down the words that he mispronounces and practice them with him during each therapy session. Make him a list of the words and ask him to practice them at home.
Since /s/ and “sh” are stopped, I would try to tackle both at once. You are on the right track by having him a pause between the consonant and vowel sounds. Gradually reduce the pause in your production when giving the model. Once he can produce CV with barely a pause, tell him that he needs to now slide the sounds into the next sound. Raise your arm to prepare for a visual sliding motion as you say the CV combo. In other words, as you say /s/ or “sh” you’ll motion a slide with your arm and end with the vowel. You can also preface by telling him he is inserting a /d/ after the /s/ or “sh” and he needs to work on sliding the /s/ or “sh” into the next sound without the /d/. If he must have a slight pause with CV, I would still move him on to words, initial position and do the same as you did for CV.
I would hold off on /r/ for now.
Tags: articulation, behavioral issues interfering with therapy, phonological disorder, speech problems, speech therapy
Posted in Articulation Disorders, Behavioral issues in therapy, Communication Disorders, Phonological Disorders, Special Education, Speech Disorders, speech therapy | Comments Off
September 15th, 2009
Problem: I’m working with a 4yrs old. who substitutes a “l” for “t’ and “th” e.g he will say “le” for “the”, “male” for “matter”, but it is not consistent across all word positions and words. What would you suggest?
Since he does use /l/, although inconsistently, I would recommend writing a list of /l/ words for him to practice. Practice these words daily. You can add to the list whenever another mispronounced words comes up.
Tags: articulation, speech problems, speech therapy
Posted in Articulation Disorders, Communication Disorders, Speech Disorders, speech therapy | Comments Off
August 29th, 2009
When I test a child, I do a battery of formal tests and a spontaneous language sample. For an spontaneous language sample, I audiotape a conversational sample of a child’s speech (50 to 100 utterances) and analyze it. It offers a lot information about grammar, syntax, semantics, pragmatics and and overall conversational skills.
Tags: articulation, Language Therapy, phonological disorder, Speech and Language Testing, speech therapy
Posted in Articulation Disorders, Communication Disorders, Language Disorders, Language Therapy, Language problems, Special Education, Speech Disorders, Speech and Language Evaluation, Speech and Language Testing, speech therapy | Comments Off
August 26th, 2009
Thank you Congressman for the phone town hall meeting you just held. Unfortunately, there was not enough time for my voice to be heard.
I am very much for health care reform. For many of us, a job with health insurance can be a more important factor than salary.
I work part-time as a speech pathologist in one of the local school districts. Reimbursements for speech therapy services in the schools comes from state and federal monies. The result of that is that I have an overwhelming amount of paperwork. The burden of the paperwork is so huge that and time consuming that it takes the place of my being able to see children more often. I often say that I see the children in order to do the paperwork. And to be perfectly honest, much of the paperwork is nonsense. When it comes right down to it, I am being paid to do clerical work for government bureaucrats rather than helping the students for whom I was hired. This leads me to my biggest concern with universal health care—paperwork. Will the doctors be burdened by so much paperwork that the patient will take second place to it? Will the government hire an army of bureaucrats to police the doctors? If so, universal health care will indeed be far more expensive than it will need to be.
One more thing. Abortion should be treated like any other medical issue and should not be subject to government regulation. Once health care does not cover for one procedure because of someone’s beliefs, then it leaves itself open to noncoverage for many medical procedures that may not be to one or another’s liking.
Posted in Health care reform | Comments Off
August 18th, 2009
Problem: I am working with a child who is not motivated to do anything during the session. The only thing he enjoys doing is spinning in my chair, which he does immediately upon entering the room.
Since spinning in the chair is motivating, I would use it as a reward for cooperating and doing what is asked of him. Seat him in a stationary chair. When he successfully accomplishes the task at hand, he gets to spin in the chair. I would limit the spinning to one or two spins. Then he returns to the other chair and to his work. You can up the ante a bit too. If he does _________, he gets to do one spin. But if he does ___________, he can spin two times.
Tags: behavioral issues interfering with therapy, speech therapy
Posted in Behavioral issues in therapy, Language Therapy, Special Education, speech therapy | Comments Off
August 18th, 2009
Problem: I have a 4 1/2 year child who devoices /b/ and /d/ and produces them as /p/ and /t/ respectively. What should I do?
I would work on getting this child to understand the concept of voicing. If he is at least 4, I would talk about the voice box and that we can feel it work (If he is closer to 3 years, don’t bother talking about the voice box). Have him cover his throat with the palm of his hand as he feels it work when he hums and coughs. Compare this feeling to what happens when it doesn’t work—blowing air and whispering. Next compare the feeling for voiced and unvoiced sounds that he is able to produce ( I guess I am assuming that there are voiced sounds he is able to produce). Try giving him a string of voiced sounds, randomly throwing in /b/ and /d/ without warning. Gradually increase the occurrence of /b/ and /d/ in the sequence until production becomes consistent.
Tags: articulation, phonological disorder, speech problems, speech therapy
Posted in Articulation Disorders, Communication Disorders, Phonological Disorders, Special Education, Speech Disorders, speech therapy | Comments Off
August 13th, 2009
Problem: The child talks too quickly and is hard to understand in conversations.
Some children do not clearly articulate consonant sounds in conversation. This can make their speech sound excessively fast. In such a case, I would encourage clarity by telling her to, “Say all your sounds.” When a child focuses on saying sounds clearly, she will generally slow her speech down to do so. On the other hand, she may be talking too fast and, as a result, drops consonant or compromises consonant sounds. In this case, I would make some “speeding tickets.” I would tell her that when she talks too fast she is speeding. Explain that when cars go too fast, people get speeding tickets. When she speeds, she will get a speeding ticket. I like to have treats or stickers ready. If they stay under a certain number of speeding tickets, they get ___________ as a reward at the end of the session. If they go over, no reward.
Tags: articulation, speaking rate, speech problems, speech therapy
Posted in Articulation Disorders, Communication Disorders, Fast talker, Speech Disorders, speech therapy | Comments Off
August 13th, 2009
Problem: When teaching a child to say /s/, he is able to maintain the correct tongue position but then clenches his teeth when he says the whole word.
Clenching is his way of ensuring that he keeps his tongue in correct placement. I would handle this by telling the child that he does not have to keep his teeth together for the whole word, only the /s/. Actually, I suggest trying to handle this issue at the syllable level first—CV (consonant-vowel) and VC. Try starting with CV. Demonstrate how to say combos like say, see, sigh, so , sue. Keep your teeth together for the /s/ and then open for the vowel. Have him repeat each syllable after you.
Tags: articulation, lisp, speech problems, speech therapy
Posted in Articulation Disorders, Communication Disorders | Comments Off
July 21st, 2009
Would you recommend working at sound level at all? What about oral strengthening exercises for the dysarthric features?
If the child has a large enough repertoire of sounds there is no need to work at the sound level. Take him to the next challenging level. If I am assuming correctly, that “oral strengthening” exercises are the same as oral motor therapy, then there is no evidence that “oral strenthening” exercises are of any benefit. Rather, I would observe and note which sound transitions are challenging for him and then work on those transitions. For instance, let’s say that he has difficulty transitioning from /k/ to /t/ as in “back to” I would start out asking him to repeat /k/ — /t/ one right after the other. If this is easy, move him on to two word combos: take to, make time, etc. Short sentences would be the next step. The idea is to determine the level of breakdown and work from there.
Tags: articulation, Dysarthria, phonological disorder, speech problems, speech therapy
Posted in Articulation Disorders, Communication Disorders, Dysarthria, Phonological Disorders, Speech Disorders, speech therapy | Comments Off