Archive for the ‘Special Education’ Category
Thursday, 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
Saturday, 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
Tuesday, 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
Tuesday, 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
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Monday, July 20th, 2009
Re: I see Ben once per week for 30 minutes, usually at his school.He has made progress in therapy, but it has been slow and limited and his speech remains very inconsistent.
What can be done to help a child on a 1/2 hour schedule once a week? Very little to nothing, unfortunately. I say this because your heart and mind are in the right place in trying to help this child. He is severe so I hope you are keeping your expectations in check. The good news is that his mom sounds as if she is involved.
Tags: articulation, how long does speech therapy take, parental involvement, phonological disorder, speech problems, speech therapy
Posted in Articulation Disorders, Communication Disorders, Parent Involvement in Therapy, Phonological Disorders, Special Education, Speech Disorders, speech therapy | Comments Off
Tuesday, July 14th, 2009
I recently started working with Ben (age: 5;3) who is in Kindergarten.
-His prosody is close to monotone
-His speech sounds and looks effortful. It is slow and he over- articulates his sounds (e.g. his mouth opens wide). His mother and teacher report that his clarity drops significantly with fatigue. His
performance varies from session to session (e.g. /ch/ isolation 100% one week, 60% the next „³ /sh/)
- He appears to be simplifying his syntax not just because of his language delay but also due to the limitations of his articulation (he can say grammatically correct sentences when prompted to, but generally sticks )
- Feeding: Ben takes a very long time to chew hard/chewy foods (e.g. a carrot). I am planning to look at his feeding when I see him next.
I am wondering if this child has dysarthria. I would recommend that you speak with the parents about having a pediatric neurologist see their son.
Re: Previous goals have included- phonological awareness skills (e.g. syllabifying words- if he has trouble saying a word now his mother prompts him to clap it out & he is generally successful at saying it- e.g. spaghetti) & /l/ clusters. He can syllabify words with up to 4 syllables by clapping and imitating. He can say /l/ clusters at
word level, but sometimes breaks down at higher levels. When he says /l/ clusters at word level he segments the sounds a little (e.g. b-lue) like he is trying really hard to make all the sounds. He had also been working on rhyme identification but with little success (I have abandoned this goal). Mum reports that he has improved a lot since the beginning of the year (meaning that his speech is easier to understand).
- He has inconsistent processes (deaffrication tch„³ts, consonant
harmony dog„³gog, WSD, CR). When asked to copy an adult model at single word level, Ben can do so accurately (although at a slower rate). At phrase & sentence level, Ben distorts and omits sounds and syllables including vowels.
I think at this point I would focus on consistent sound production at the phrase level in repetition tasks. I would focus on all sounds in his repertoire. I would also compose a list of words in which consonant harmony occurs and work on correct production of those words. Identifying a pattern, such as consonant harmony in words beginning in /d/ followed by /g/ (as in your example), will help narrow down the word list possibilities. Using the /d/-/g/ example, a sample of appropriate words would include: dig, dug, dagger, drag.
I agree with your decision to abandon the previous focus on phonological awareness and focus instead on helping this child communicate more effectively.
Tags: articulation, phonological disorder, speech problems, speech therapy
Posted in Articulation Disorders, Communication Disorders, Special Education, Speech Disorders, speech therapy | Comments Off
Saturday, July 11th, 2009
I am a new SLP and I am trying to expand my ‘toolbelt’ and work on the education side of speech tx. I have a general question but it is something that perplexes me. As an SLP in schools, how do you work with a group of students that have different sounds to address but you are for example, treating four different students with four different errors in the same hour or half hour session. I have some ideas but there is an entire school year to plan! I’d appreciate any advice!
I’m not sure what you me by “work on the education side of speech tx.”
Providing therapy for four students with four different errors in one session will be challenging. Why are you arranging such large groups? What do you realistically expect to accomplish with each student during the school year?
One of my primary criticisms of school based therapy is the length of time it takes to help children with speech and/or language disorders. There are several factors that influence the length of time a child stays in therapy. One of those factors is the size of the group. The larger the group, the more difficult it is to address the individual needs of each student. If the group is not homogeneous in problem addressed and age, your job difficulty will increase.
Tags: how long does speech therapy take, speech therapy
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Saturday, July 11th, 2009
Just assessed a seven year old boy yesterday who is likely the most severe I’ve come across (i.e., highly unintelligible for his chronological age – although mental age may be lower than CA and may account for some of his speech delay). He presents with use of the following phonological processes: fronting, stopping, cluster reduction, weak syllable deletion and gliding. What I found unusual (and haven’t come across before) is his substitution of /h/ for /k/ in word initial position (hup for cup, for instance) (also, occasionally substitutes /h/ for /t/ in tr-blends and in word medial position).
A few years ago I worked with a 5-year-old child who substituted a snorty /h/ for most inital consonants. He deleted most medial and finals. Needless to say he was unintelligible. There were no physical abnormalities.
There were many sounds that this child was able to produce but did not use. I began therapy by targeting /k/ and /g/ followed by /w/. Once these sounds were learned I targeted all consonant sounds in his repetoire at once. The progression was: CV and VC, words, word pairs, word pairs in sentences, medial position, random sentences, elicitation during play, and finally conversation. I introduced /l/, and /r/ separately towards the final stretch.
Tags: articulation, phonological disorder, speech problems, speech therapy
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Wednesday, July 8th, 2009
Re: I think that 3 to 5 year olds are not an easy group to work on with pure articulation work.
I have found that this age group can be easier to work with than older children for a number of reasons. They are eager to please and not burdened by what others will think when they make a change in their speech. The psychological impact of speech problems, consider teasing, has not yet become much of an issue. They tend not to be involved in as many activities as older children so that therapy doesn’t mean having to miss soccer, gymnastics, etc. Equally important, children should begin academics without the burden of speech problems.
On average their oral motor skills are good enough so that the majority of children in that age group are able to produce most English
consonant sounds. A 3-5 year-old child with normal oral motor functioning should be able to do the same with therapy.
Tags: articulation, preschool speech therapy, speech problems, speech therapy
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Wednesday, July 8th, 2009
Re: I have recently started seeing a little boy aged 3 years 3 months. He is able to imitate most sounds in isolation except for y, f, or j. He is very co-operative and his attention is great – he will sit the table and co-operate for games for a 30 minute session. I don’t really know where to start with him.
When working with a child of this severity, but who is stimulable for many sounds he doesn’t use, I would start with CV syllables for all sounds he is able to produce. Once he achieves consistency with CVs, I would introduce words that start with all those sounds. I would ignore final consonant deletion for now. Once he can say words consistently using the established and “new” consonants, I would move him on to two word repetitions using any combination of initial consonants: see girl, two books, nice move and so on. From this point, when you feel he ready, I would introduce short sentences with the expectation that he will be able to repeat them using all the sounds he will then have in his repetoire. While he is working on short sentence repetition, I would start him on VC syllables and then continue the process as above.
Tags: articulation, speech problems, speech therapy
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