Help Me Talk Right

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.

Re:  I am working with a boy who is turning 3 this month.
I would appreciate any insights into what’s going on with him and how I might work most efficiently with him. He’s been struggling with blowing bubbles. He was drawing his lips together horizontally, but then he was not able to direct the air. I taught him to think “u” and then blow out. It got it the first try and their is nothing like success to keep you trying. Today–about the 4th day he’s been asking to blow bubbles, he had to set himself up to say “u” (he reminded himself–he didn’t need me to say a word), but then it took him a while to figure out how to blow out through the mouth shape. He was successful, but missed as well. He presents with a number of phonological errors including final consonant deletion except for [p]. I was able to elicit a final [t] in “out” by elongating the vowel and exaggerating the final consonant punctuated by a gesture of finger tap to side of my mouth. All other [t, d] he says via backing. His articulation is somewhat inconsistent in that at times, I think I hear [t,d] correctly placed, but overwhelmingly, his phonological process of choice is backing. He backs [s, t, d] and sometimes even [m,n]. Today he said “pickle” perfectly the first time and every time he said it again, he couldn’t sequence it properly. I don’t have a way to record his speech and was not able to recall in the context of play, how he said it. I suspect he assimilated the [p]. He produces all bilabials, although we had to work on [w] and it is not stable in all contexts. He can produce [n, s, z] in sounds but become backed in words. [d, t] are always backed. At one time he was able to say [l] in blends with bilabials. I haven’t listened for that recently. [sh, ch, dg] are distorted at sound level (he was getting some lateral fricative production, but thankfully is now producing central air stream). He says [k,g] although at times his [k] is voiced. He can produce [j] in some contexts, e.g. “yeah” but trouble with “PU!” He can say “you” and even “no, you!” The more he tries to say, the less accurate all his words are. The more syllables in a word, the less clear the word is going to be.

It looks to me as if you are working on too many things at once. Based on you description, I would probably begin working only correct production of all frontal sounds starting out in isolation. That would be /s/, /t/, /d/, /m/, /n/, and /w/ (possibly /l/ too). I would use his successful production of /w/ and the bilabials to help him understand using his lips to produce /m/, sh, ch and j. With the other sounds I would do one of 2 things:
1. Have him feel his tongue tip with his finger. Then play a game whereby his tongue tip moves in different places (those places being of course where the tongue tip will need to be for the eventual production of the sounds). I think this guy will need to experience a lot of success and confidence handling these movements before you introduce the sounds themselves. When you feel he’s ready introduce the movement of the tongue for /t/, /d/, /l/ and /n/, without sound. Once he can consistently get the movement with the placement, introduce sound.

2. /t/, /d/, and /n/ can be approached interdentally at first. (I would hold off on /s/ for now with this approach.) To do this, you ask the child to stick out his tongue (can he do this?) and softly bite his tongue. Once he can do this consistently, introduce sound. Make sure you tell him that he has to keep his tongue out—it’s not allowed to go back into his mouth.

Once the above sounds are attained in isolation begin CV. I would ignore the final consonant deletion and other errors for now. Make sure to maintain his level (isolation or CV) with the phonemes he correctly produces.