Posts Tagged ‘phonological disorder’
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 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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Tuesday, 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
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
Monday, July 13th, 2009
Overgeneralization is something I often encounter when a child has learned a new sound and is trying to sort out when to use it. It’s almost as if the child has decided to cover all of his/her bases. What I tell the child at that point, and ask the parents to do the same is, “That word doesn’t have a ____ sound. We say______ (correct production).”
Tags: articulation, phonological disorder, speech problems, speech therapy
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Monday, July 13th, 2009
When a child first starts therapy with me I prefer to target stimulable sounds. I feel that one can achieve success quicker when the sound is stimulable. Why is quicker success important? I feel it lays a positive psychological groundwork therapy (and parents as well).
I feel that one of the important considerations in therapy is targeting that which will have the greatest impact on intelligibility. That might mean targeting FCD before a specific phoneme. It could mean targeting more than one phoneme if the child demonstrates h/s can handle it.
I generally target /r/, /l/, and frontal or lateral /s/ towards the end of treatment. I haven’t found that targeting the least stimulable of these has any impact on the acquisition of the others.
Tags: articulation, phonological disorder, preschool speech therapy, speech problems, speech therapy
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Monday, July 13th, 2009
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: phonological disorder, preschool speech therapy, speech problems, 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
Posted in Articulation Disorders, Communication Disorders, Phonological Disorders, Special Education, Speech Disorders, speech therapy | Comments Off