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Monday, April 18, 2011

ELICITING SOUNDS- /l/


Little Linda lives alone

Lonely little Linda

Has no one to call her own

Lonely little Linda

If you are as old as I am, you will recall this practice poem from The Big Book of Speech. I never think of the L sound without recalling that poem, so, of course, I had to include it. I found it to be a terribly depressing poem and I always felt so sorry for little Linda. I have always hoped she one day found someone of her own, but if not, she at least helped thousands of kids habituate the L sound.

The L sound is usually so easy to correct. It’s the “singing sound” la-la-la-la-la ♫. Kids can pick up and imitate that so easily, right? For the most part, but it never fails one kid will come along who just cannot get the correct placement. What do you do for that child? Today Leah and I will share our tips and tricks of how we do it.

TIP #1: Jaw Stability and Segmentation

The child must have good stability of the jaw and must be able to segment the articulators. He should be able to hold his mouth open and lift his tongue tip up to the alveolar ridge without any jaw movement. All movement should be from the tongue and independent of the jaw. There should be no lip movement either.

While I am not going to get into the oral motor debate regarding NSOME (Non Speech Oral Motor Exercises), I am going to tell you that the exercises that I have used have been exceedingly beneficial in teaching the child how to achieve jaw stability and segmentation. Once those skills were learned then regular articulation therapy could begin. I would even go so far as to say that taking the time to ensure the child had good jaw stability and could segment his articulators decreased the amount of time spent in therapy working on the L sound. When it comes to articulation therapy, I think we are all guilty of rushing into production and not spending time preparing the child for speech.

Personally, I (Dean) am a huge fan of the bite blocks from Talk Tools and Sara Johnson’s procedure to teach jaw stability and tongue tip elevation. Pam Marshalla has techniques for this as well. Just remember oral motor exercises are not the goal of therapy. Your goal is /l/ in isolation in this case. The exercises are to facilitate correct production.

TIP #2: Tongue Tip Elevation

Once you have established good jaw stability and segmentation you can begin to work on tongue tip elevation. For some kids this is not a problem now that they have learned to separate the tongue and jaw, but for others they need a little more help. A very effective way to do this is to use Cheerios or Fruit Loops cereal. Actually any cereal with that shape will work well. The idea is that the child will hold the cereal up to the alveolar ridge using the tip of his tongue to achieve correct tongue placement. Full instructions for this technique can be found in the Talk Tools manual. I do not know if sharing them here with you would be an infringement of copyright or not, so I will err on the side of caution and simply tell you where you can find them.

TIP #3: Shape from Interdental /l/

If the other techniques are not working for you, you might want to try this. Have them place the tongue between the teeth touching the upper lip. From there you shape by gradually moving the tongue to behind the teeth.

TIP #4: Smile

A quick remedy to eliminate lip-rounding-or /w/ for /l/, when they are at the syllable or word level, is to tell them to smile broadly when saying the stimulus. Important: Choose your stimulus syllables and words carefully here as you do not want to choose words in which the lip rounding is needed to say the word. You’ll be setting the child up for failure if you do. Good vowels to use would be: lay, Lee, lie. You want to avoid low and Lou because the vowel will cause lip rounding and that is what you are trying to teach them not to do. Also, avoid words ending in lip sounds as you do not want them to use their lips at this point in therapy. Good words to use: lake, late, lazy, etc. You can use the word ”line” but not the word “lime” because lime uses the lips. You can use the word “leak” but not “leaf.” I’m sure you are following me. Just give thought to what you are having them do. Once they can say these words with sufficient accuracy you can then introduce all the other L words.

TIP #5: Dark L (final /l/)

When I was in school 100 years ago we were taught there were two sounds for /l/. There was a “light” /l/ and a “dark” /l/. I actually do not know if it is still taught that way but will share this with you because I found it handy when teaching the final /l/.

The “light” /l/ is your initial and medial sounding /l/ or the “la, la, la.” The “dark” /l/ is the final /l/ and has more of an “uhl” sound to it. In the area of the country in which Leah and I live, the final /l/ is often dropped from the words. Pool is pronounced “poo” and school is pronounced “schoo” Being anal, I take the time to teach it correctly even though it is probably considered a regionalism.

The easiest way to get the final L is like this:

1. Have to child say “ah” or “uh” and continue to voice it (say it for as long as they can keep it going)

2. Next, as they say “ah” have them slowly move the tongue tip up to the alveolar ridge for the /l/

3. At this point it should sound like “ahl” or “uhl” depending on which vowel you were using.

4. Now tell them freeze the tongue in that position (tongue tip up) as they stop the sound. It is important that the tongue stay up in position after the sound has ended to eliminate them saying “luh” at the end of the word (ball not balluh, etc)

5. Once they can do this successfully on several words you can usually move right along with traditional therapy.

I also use hand cueing for when to stop the sound. I say the sound with them as they are learning and gradually fade my voice so that only they are saying it.

I cannot remember where I learned this technique but do want to make it clear that this is not my original idea. However, Pam Marshalla teaches it this way, so I probably learned it from her J here’s the link to her site: http://www.pammarshalla.com/qaeach/07_18.html


TIP#6: Clusters

For the kids who insert a schwa between the consonant clusters of bl, pl, etc, (puhlay for play, buhlue for blue) a quick trick is to simply tell them to say both sounds at once. I tell them to get their tongue ready for L and hold it and then put their lips together and say it at the same time. May take a few tries but they seem to understand what they are supposed to be doing this way.


Make therapy fun for your kids this week! HAPPY EASTER!

Leah and Dean

www.2galsspeechproducts.com


8 comments:

  1. Love your reasoning for why to use the oral placement techniques...I always have felt that a combination of approaches is best. Also, love the cluster technique. Looking forward to trying that one as I think it will bring about faster results than how I do it. :)

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  2. Very interesting for an SLP student like me to see the intervention in such details cause we don't have to talk about each phoneme in class. Thank you!
    @evelynefrench

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  3. Any thoughts on teaching and getting the child to differentiate /l/ from /n/?

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  4. Hi Danielle! Funny you should ask that because I had that as Tip #7 and then lost it when I forgot to save! LOL

    To get a child to differentiate /n/ from /l/ teach it from the perspective of where the sound is coming from nose or mouth. I assume the child is substituting /n/ for /l/. Say words yourself and have him/her "feel" on your face when you do minimal pairs of N-L words. Line-nine, etc. or even syllables knee-Lee; no-low; new-Lou, etc. Then have him feel on his face when he says the /l/ syllables or words. Focusing on the nasal-oral comparison should do the trick. It worked for me :) Good luck!
    Dean

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  5. Hi I find this very interesting, I am now working with a 5;6 boy who cant say /l/ sound and is not stimulable for it either. I tried the cheerrios but it did not work, I tried pairing it with the vowel without success. I have cued for smiling when saying the sound. He can't say the /l/ in clusters, and I have tried shaped for interdental but he cannot do it. Do you have any suggestions for me? What I'm doing right now is play based and just incorporate the /l/ in the activities, do you any tips or ideas that can help me?
    Thanks!

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  6. Hi Lidiette thanks for your comment. I would say that at 5yr 6mo the /l/ should certainly be emerging or acquired, so targeting it is a realistic goal. A brief paragraph doesn't tell the whole story on this child, so my comments must be taken with that in mind. :)

    You have tried several things and that is good. If one technique doesn't work we have to try another and another and another until we find what does work. The only question I have for you is did you try each technique for 3 consecutive sessions? I always try 3 sessions before saying a specific technique isn't going to work. Sometimes we just don't give it enough time.

    My GUESS and this is just a guess here since I haven't seen this child is that he may not have good jaw stabilization. Without good jaw stabilization you aren't going to get the sounds correctly. You need a good foundation to build anything. I suggest you investigate that idea. Can he open his mouth wide and lift his tongue independently of his jaw? If not then he hasn't learned to separate jaw/tongue. Talk Tools sells the bite blocks and a manual for using their tools.

    Here's a link to the bite blocks http://www.talktools.com/bite-block-jaw-grading-red/

    Here's a link to the manual for Oral Placement.
    http://www.talktools.com/oral-placement-therapy-for-speech-clarity-and-feeding/

    I used this with a 5 yr old child once who was making no progress with the /l/ and had really good success.

    Good Luck!
    Dean

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  7. Hi
    Thanks for all the great tips. Any to help distiguish L from Y?

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