Top 10- #4 Eliciting K

When I originally wrote this post on April 18, 2011 I had started by offering my sympathies for the devastation caused by the tornadoes in Oklahoma, Missouri, etc.  I find it almost incomprehensible that as I repost this article I have to once again begin with condolences, sympathies, and disbelief. The senseless killings and lost of life that occurred over the weekend leaves me very confused and astounded.  May God comfort those who mourn......

(Here is the post from 4-18-2011 on eliciting /k/)

I have often felt baffled by why kids cannot produce /k/ when developmentally we make posterior sounds before anterior. Think about it, a baby’s first sounds are goo-goo and ga-ga, so isn’t /k/ just a naturally developing response? It makes me go, hmmm. Luckily there are several ways to go about teaching this sound. These tips are not in any particular order, so don’t think Tip #1 is the best. All these tips have been used successfully by us and as you know what works with one child does not always work with another. We are simply sharing some ideas of things to try.

TIP #1 Cue with “Clear out the Popcorn”
I have found that the major reason a child cannot to imitate a sound from our model and demonstration is simply that they don’t understand what we are telling them to do. They just don’t “get it.” It also seems that they more often than not just don’t get it when we try to show and explain how to do those sounds that are made in the back of our mouths: /k/, /g/, /r/. So to help them “get it” I try to relate the sound to something to which they are familiar. Most all of us have eaten popcorn and don’t we all, at times, get a husk caught on the back of our tongue and have to clear it out? That is what I use to help them understand what I mean by back of the mouth or back of the tongue, etc. Every child I have had in therapy can show me with 100% accuracy where the front and back of the mouth is on a drawing and can point to the front and back of their own mouths, but yet cannot put their own tongues there. So to teach them how to find and lift the back of their tongues, we practice that horrible hacky-growly guttural sound we make when clearing out the popcorn. We do this until I feel they fully understand what I mean when I say use the back of your tongue. Once they “get it” you can shape it into a beautiful /k/ in isolation and begin your regular therapy. If they forget to get their tongue up when drilling syllables or words, just cue with “clear out the popcorn.”
If you really want to be the fun “speech teacher” why not bring some popcorn to eat in therapy? Just check for food allergies first ;)
TIP#2 Cereal
You can get correct tongue positioning for /k/ using cereal-Cheerios or Fruit Loops. This approach is taught by Sara Rosenfeld-Johnson in her Talk Tools program. Basically what you do is place the cereal behind the bottom front teeth and have the child place the tip of his tongue in the cereal hole and hold it there to keep the tip down while making the /k/ using the back of the tongue. This technique is explained in detail in the Talk Tools program. Here is the link to the website. http://www.talktools.com/ I highly recommend you learn how to implement this technique because it is effective. It is great for kids who front the back sounds and need the tactile cuing.

TIP #3 Tactile Cues—Holding the Tip and Blade
For years I have had kids to use their own finger to hold the tongue tip down to get the correct position for /k/ when they were substituting /t/ for/k/. Many times they will have to not just hold the tip but the tongue blade as well. You can start out with them holding only the tip down while they say /k/, but if they start making the /k/ with the blade of their tongue mid palate you will have to have them hold more of the tongue down and push the tongue further back in their mouths. This has been exceptionally effective at achieving a good /k/ sound. Many people do not like this approach, but if it works then I say use it. I have had some kids who have had to use their finger to hold their tongue down not only in isolation but through syllable and even a few into words (gasp)! However, never fear, I have never had a kid graduate from speech therapy and still have their finger in their mouth!! I never ask them to quit using their finger. They eventually get tired of using it and stop on their own. Don’t you think we sometimes worry too much over the little things?
When implementing this strategy if you are the one holding the child’s tongue via your own gloved hand, finger cot, or tongue depressor be careful of a hyper gag reflex. If you find a child with a hyper gag, you have two choices: 1) desensitize the gag reflex or 2) don’t use this approach. If the child can tolerate you inside his mouth a nice little tip is to use flavored toothpaste on a dental swab. It is just less invasive tasting.
TIP# 4 Use Gravity
Some children need a little more help learning to elevate the back of their tongue, and gravity helps! There are suggestions to have the children let their head lean over the back of their chair or have them lie in the floor. Personally, I have had no success with using the chair technique. I have had success doing therapy while the child is lying on his/her back in the floor. Initially, I just have the child lie on his back in the floor and do some deep breathing exercises to help him relax. I will sometimes lay a book on his stomach for this. They can see the book rise and fall as they breathe. After the child looks relaxed and at ease with lying on the floor, I begin therapy using the other techniques explained in this article. The one that seems to work the best is using tactile cues. I will start with a tongue blade and gently “push” the tongue tip down toward the back of the mouth. If this doesn’t work, I try having the child “cough” really hard, (similar to the clearing out the throat.) Usually, this combination of techniques works within one to two sessions, and we can go back to sitting in our chairs for therapy.
TIP#5 Getting Tongue Retraction
You cannot produce a /k/ without your tongue retracting back into the mouth. To achieve a tongue retraction response, stimulate midline of the tongue from anterior to posterior with a tongue depressor or your gloved finger. Pam Marshalla explains this very well on her website Q & A section: http://www.pammarshalla.com/qaeach/07_08.html

I suppose this sums up every tip and trick we have up our sleeves. Hopefully this has affirmed that what you’re doing is right or maybe even got you to thinking it is ok to try something off the wall in therapy!
Remember kids learn more when having FUN than any other time, so have some fun in therapy this week!

Leah J Musgrave, M.S. CCC-SP
Dean Trout, retired SLP
www.2galsspeechproducts.com