TOP 10 #3 Eliciting S

My summer has been very busy with helping my son and daughter-in-love move back to the area, buy a house, and settle in. I am sure those who looked at last week's post was terribly confused by my mistake.  (Mistakes...hmmm, I tend to make several of those.)  Anyway last week's post was on eliciting K although the title said L.  I have corrected the title so it now reads Eliciting K. My sincere apologies, but those who have been following me for these past two years know to expect my mistakes....proof that I am human and not automated ;)

(This is a reprint of our post from March 28,2011 on Eliciting S.)

ELICITING SOUNDS- /s/

Today we will be focusing on tips and tricks for eliciting /s/. There is much to say concerning the different error patterns for /s/ and I don’t like long blog posts (reading or writing them) so I’m reserving tips and tricks for the lateral /s/ as a separate entry. We will focus solely on the Lateral /s/ in next week’s blog.

How to produce the /s/ sound. The correct production is made with the teeth nearly closed in a natural bite position and the lips parted as though smiling. The sides of the tongue are raised against the upper side teeth. The tip of the tongue may vary as to the position, but is usually raised to approximate a place behind the upper front teeth. The tongue should form a groove down the center, through which the breath is directed in a continuous stream. (Judy Kuster, A Collection of Approaches to the “S” Sound).

Tip #1-- Be careful how you label sounds.

The /s/ is most commonly referred to as the “snake” sound, but for some of your students this may actually hinder the correct production. Take for example a little boy (or girl) who is really into reptiles and knows more about them than any of us would want to know. They will argue with you that the tongue should protrude while you hiss. This is not good if you are trying to correct a frontal lisp (th/s). I have also read some SLPs call it the ”Mad Cat Sound,” but I use that label for teaching /f/ not /s/. There are other ways to make an association for the /s/ that will be effective at conveying the idea of a hissing sound. One that I particularly like is the “Flat Tire” Sound. (This label is not ours. It came from an articulation program I was using several years ago.) There is no one particular universal label, so use what works for you, but give thought to what that particular label might be implying.

Tip #2—Tell the child to smile.

That may sound like a no brainer, but sometimes that one little adjustment will make a world of difference in the quality of the production. Smiling broadly moves the lips off the teeth and gives a little tension to the lips. Usually the three step direction, “Put your teeth together, smile real big, and blow” will result in correct production.

Tip #3— Where is the tongue tip?

The /s/ sound can be made with the tongue tip in one of three positions, up, down, or in the middle. If I took a poll of everyone reading this blog it would probably be evenly distributed among those three positions. There is not a preferred position. Use what works best for that client.

You can alter the tongue tip position to eliminate some of the more minor problems encountered with /s/. If the child is “dentalizing” the sound (letting the tongue touch his teeth when producing the sound), have him place the tip down below the bottom teeth or up towards the alveolar ridge and that will eliminate that problem. Odds are, the child’s tongue tip is in the middle, so moving it up or down will get it off the teeth. If a child is creating a whistle on the /s/ have them lower the tongue tip to the middle or down below the teeth. I have had success with fine tuning the tongue tip position.

Tip #4—Prolong the sound with tactile cueing.

Sometimes we encounter kids who appear to have insufficient breath support for the /s/ when in reality they do have the breath support, they just aren’t controlling it effectively. Rather than go into all the exercises for breath support, I first try this little trick. Have them take the index finger of the right hand and draw it slowly up their left arm as they say /s/ going from the wrist to the shoulder. Works like a charm! Once they have the desired /s/ in isolation you can shorten the length or speed of the tactile cueing or simply fade the cue.

Tip #5—Eliminating Stop Sounds

Carolyn Bowen has a wonderful aspiration trick on her website http://speech-language-therapy.com/index.php?option=com_content&view=article&id=37:consonants&catid=9:resources&Itemid=117 It works very well for those children who “stop” the /s/ by saying /t/ for /s/. (i.e., “tun” for “sun.”) Often you can get them to correctly say the /s/, but then they insert “their” preferred sound afterward. Now, instead of saying ‘tun,” they’re saying “stun!” To help them eliminate the stop, have them insert /h/ (or aspirate) after they say the /s/. It will sound something like this: “sssssss”+ “hun.” Some others are “soap” = /s/ + “hope, “see” = /s/ + “he.” Using the /h/ prevents the insertion of the stop. There are numerous pages available on Carolyn’s website that have this concept already illustrated, so you don’t need to create your own!

Tip #6—Teach /s/ blends first

Barbara Hodson, is a big believer in teaching consonant blends first to the child who omits s-clusters when doing a phonological cycles approach. (This is not for substitutions or distortions.). She recommends adding the /s/ to a consonant the child already produces. The clusters typically taught would be /st/, /sp/ and /sm/. She also suggests adding word final (e.g., /ts/, /ps/) after the child can produce the word initial s-clusters. This would usually be by the 3^rd cycle. To incorporate the /ts/, the simple phrase “It’s a _____.” can be used. For the /ps/, you might use “Cups of ____.” or “Hops on ____.”

Leah and Dean

Leah J Musgrave, M.S. CCC-Sp

Dean Trout, retired SLP

www.2galsspeechproducts.com

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

TOP 10- #5 Eliciting Sounds-R

 We have reached the midway point of the summer reprints of our most popular blog posts.  I hope having these reviewed again will make it convenient for you to access when you start back to school, as well as serve as a reminder when you try to recall where you saw that resource. 

As a peek into the future I will share that we are trying to work ahead on the fall entries and develop some useful posts regarding tips/tricks and effective strategies for using our products. If you have ever came by our booth at conferences you know that Leah and I take time to share with you how we adapt our materials to fit our needs so we thought we would put that in a blog series so you could benefit too! Not only our ideas but the creative ways others have shared with us about how they use our materials, so we know that you too would find that beneficial. I find working on these future posts both refreshing and exciting!

Now for today's repeat blog on the R sound..

(Reposted from May 22, 2011)

ELICITING SOUNDS /r/

 We are going to talk about /r/ which has been labeled by many as the "hardest" sound to teach. There are many suggested techniques to try so keep in mine these two things: 1. go with the strategy that you are most comfortable and confident and 2. keep trying different strategies until you find one that works for the kid sitting in front of you. Just because it worked with the last kid does not mean it will work with this one! Now with that in mind here are our tips.

TIP #1 Visual Verbal Label

I’ve heard the R sound labeled as many different and creative things. Here are a few from which you might wish to choose: (1) the Rooster Sound; (2) Growling Dog/Bear Sound “grrrr”; (3) the Seal sound; (4) the Siren Sound; and (5) the Pirate Sound. I think your choice will be guided by the particular R sound you are trying to teach, as well as, with which the child can identify.

TIP #2 Shape from /i/ (long E)

Have the child produce /i/ several times until s/he can grasp the concept that the tongue is wide and touching the sides of the upper teeth midway back in his mouth. Once you are sure they fully understand and have control of their tongue tell them to keep the tongue touching their teeth as they slide the tongue all the way back to their molars. They should shape from /i/ to an /r/.

TIP #3 Shape from /j/ (Y sound)

This utilizes the same basic approach as for /i/. You are going to say /j/ as they move the tongue back until it comes out /r/. The difference is that the /j/ will position the tongue higher in the mouth!

TIP #4 Manually Move the Tongue Back

There are an assortment of things you can use to push the tongue back. One is the ever popular tongue depressor, but I’ve never liked it as I feel like I’m hurting the child. (That’s just my personal opinion.) Instead I use a dental swab. I push the tongue back with it and have the child bite on the stick portion that is now extending out of their mouth to hold placement and tell them to say /r/ after me (with the dental swap in their mouth). I like this because it keeps the child from relaxing the tongue and sliding it under the swab, due to the sponge on the end. It is just one of those things that works for me.

I read just this week in a blog by Alexandra Streeter (http://community.advanceweb.com/blogs/sp_2/default.aspx) that she likes to use a dental floss holder as a tongue placement tool for R.

There is also a product called Tongue LifteR that is readily available in the speech catalogs. I’ve never used it.

There is a new product on the market called Speech Buddies that are designed to get correct tongue position for R and a few other sounds. I have not tried them personally, so I can’t attest to their effectiveness, but the premise sounds like it would work wonderfully!

TIP #5 Cue with WIDE, UP, and BACK

I verbally cue with those words to remind the child of correct placement. The tongue has to be up high, all the way in the back of the mouth, and it has to be wide-touching the side of gums above the molars! I also use a hand signal as I am saying that. My hand signal is the letter Y from the manual alphabet, which represents wide for my purpose, I move it up high and back beside my face as I give that cue. I fade the verbal cue and use just the hand signal as therapy progresses. Leah uses this cuing as well and reminds us that instead of moving our hand towards the back of our mouth, to move it forward towards the child for further emphasis of back in their mouths.

Again referencing Alexandra Streeter’s blog, she suggests using peanut butter on the sides of the molars to cue for placement. I would also remind you to check for food allergies before using food products in therapy ;-)

TIP #6 SMILE

A simple strategy to eliminate the insertion of /w/ is to tell the child to smile. You just can’t say /w/ while you are smiling!

TIP #7 Touch Above Back Teeth

As you have heard me say 1000 times already in previous posts, some kids just don’t “get it” when it comes to what you are wanting them to do and many times all it takes is a simple adjustment in our instructions. One such adjustment is to tell the child to put their tongue ABOVE the back teeth. That will usually get that tongue higher up in the mouth and will make a world of difference in their production.

TIP #8 R Trrrreasure

You know I couldn’t possibly write a blog without mentioning Dr. Caroline Bowen. She has an interesting strategy that involves teaching /r/ from /tr/ I’ll share it via this link

http://www.speech-language-therapy.com/tx-facts-and-tricks.html

I would like to mention a few programs currently on the market that are popular with many SLPs for working with R. (no particular order-just as they come to my feeble mind) I’m not endorsing any of these I’m just making you aware of them in case you had not heard of them.

The Entire World of R http://www.sayitright.org/EntireWorldofR.html

Successful R Therapy by Pam Marshalla http://www.pammarshalla.com/catalogue/alph/srt.html

 

Speech Buddies https://www.speechbuddy.com/

 

Let’s Learn R CD ROM http://www.violettelearning.com/index.php?page=products

Leah and Dean

www.2galsspeechproducts.com

TOP 10 #6 Othello blog by Kim Lewis

In my sequencing of our top 10 blogs, I had not realized the Othello post  had gain such a high standing, so I stand corrected.  The # 6 spot holder is the guest blog by Kim Lewis. We originally published "Othello" on August 15, 2011. Enjoy!

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I am bound and determined to have a Monday morning blog ready to go for you today. Since I am on the road traveling and can't let go of the steering wheel to write something positively outstanding, I am going to share with you a great little FUN therapy idea from Kim Lewis, M.Ed., CCC-SLP. Kim has a little website called Activity Tailor which is found at this address http://activitytailor.com/index.html So after you read this blog swing by her place and read more about her therapy ideas and her products. Thanks so much Kim for helping me out and keeping everyone safe on the road.

The following is a recent post of hers on how to use the game Othello in therapy.

I love board games and Othello is one of those classic, perfect two player games. Do you remember this one? The board consists of 64 green felted squares and each player has 32 thick black and white disks that clack snugly into a space on each turn. The tactile aspect is hugely satisfying, in addition to encouraging fine motor skills.

You begin with four disks in the middle of the board, two whites diagonal from one another and two black diagonal from one another. Decide which player is which color (black goes first).

On your turn, place a disk on the board trying to “capture” at least one disk of the other color between a previously placed disk and your newly placed one. Here’s the fun part! You turn over each disk to “your” color that falls between “your “ two ends, whether it be horizontal, vertical or diagonal. “A minute to learn, but a lifetime to master” is Mattel’s slogan, and it’s true. The game involves a great deal of strategy and is fun for both children and adults. Somewhere around 8 years old/3rd grade is where this game tends to gain popularity.

Now, let’s tailor it! I buy boxes of plain circle stickers at office supply stores. They fit perfectly inside the little squares and the felt allows them to stick but not fully adhere (so you can switch the stickers easily with no residue). On 64 circles, I write the child(s) target words and place one in each square. We then begin to play the game, saying the words we cover as well as those we uncover when we flip the disks. This is a very fun way to get a lot of trials!

I like to provide auditory stimulation, so I usually say my “own” words, but it would be easy enough to place all the production burden on the child. And the game easily adapts to carrier phrases “I cover (target word)”, “I see (target word)”, “I said (target word)”, depending on what sound you need to in/exclude from the phrase.

P.S. The rows of disks have a very Oreo cookie look to them. I think a cookie or two in conjunction with the game could be a very therapeutic experience.

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See you next week with #5 in our TOP 10.

Leah and Dean

www.2galsspeechproducts.com 

TOP 10 #7 Eliciting H-W-Y sounds

We hope you are having a great summer.  I love sharing this top 10 count down but I'm finding it a bit depressing because it is also a reminder of the time we have left before we begin a new year.  The lazy summer days are flying by, so don't put off those things you want to get done this summer.  Make a plan and do it now!

Our 7th most popular post has been our tips and tricks for getting the H-W-Y sounds.  Here is our post from 3/21/2011.

The letter Y /j/: To get correct tongue positioning for this sound shape from /i/ to /ʌ/ . Have the child practice saying just the /i/ (long E) a few times, then have them prolong the sound and say /ʌ/ (uh). This should produce an exaggerated /j/. Continue to practice this fashion shortening the /i/ until you get the perfect /j/.

You may wish to try this simple method of teaching it as the “Karate sound”. Get out of your seats and using both arm and leg movements, karate chop the air as you say an exaggerated /j/. For some kids they can do the “karate chop sound” when they cannot imitate /i/-/ʌ/. This is very effective for those children who do not understand where to put their tongue, as well as those who learn best though movement. This will not work with students who have motor issues, but I’d still give it a try because you just never know what is going to work with a particular child.

The /w/ sound : An easy way to get /w/ is to shape from /u/ (oo) to /i/ (long E). You can also shape from /u/-/ʌ/. Either of these will move the lips from a pucker to a smile which is the movement you want them to do.

The /h/ sound: For such an easy sound to produce, /h/ can be very difficult for some children to learn. One effective way is to teach it as the “Running sound”. With the wee little ones who do not like sitting still this can be a fun sound to learn. Using the gym or playground would be your best location for this but adapt as you need. Get the kids up and have everyone run. After a bit of a run have them stop and you demonstrate, in slow motion, running with exaggerated arm movements and a very audible /h/-/h/-/h/ with each arm swing. Then have the kids practice until they can produce it correctly. I find that just the arm movement is enough cueing when we work at the therapy table after they have learned the sound.

 

Some children need a visual cue for understanding that their airstream is to be directed out, not in. To help them “see” this, have them hold their hand, palm-up, in front of their mouth. Place a cotton ball on the heel of their palm and have them exhale (use whatever cue you have previously taught.) If they exhale, the cotton ball will move forward on their hand, which excites them! I have also found that it is best not to cue the little ones with the word “blow,” for that is what they do! What you really want is an exhale, so I generally tell them to “breathe” or “use your running sound,” “use your tired sound,” or whatever cue you have found that works with them.

Hope these tidbits will help you in your therapy this year. Please share with us the tricks that work for you!

Leah and Dean

Leah J Musgrave, M.S. CCC-SP

Dean Trout, retired SLP 

www.2galsspeechproducts.com