Showing posts with label Articulation. Show all posts
Showing posts with label Articulation. Show all posts

Thursday, July 10, 2014

I think my child has an articulation disorder...What can I do?

I think my child has an articulation disorder...What can I do?

First of all, welcome to Jessica Washer Speech Therapy. Simply by beginning to research what you can do you are already well on your way to helping your child receive the best help possible.  First, let's address if your child has a problem...

Does my child have an articulation disorder?
Basically, by age 2 your child should be 50% intelligible, by age 3 they should be 75% intelligible, and by age 4 your child should be 100% intelligible to new listeners. Your child may be having difficulty with individual phonemes (sounds). The following is an excellent list of the development of those sounds. You can use this list to decide if a speech therapy consultation or assessment is appropriate. (For example, if your 3 year old is still having difficulty with /r/, it's developmentally appropriate, you don't need speech therapy quite yet).

Here is a great list of sound development from teachmetotalk.com

By 18 months –
  • Child produces 3 to 6 different consonant sounds with each child having a little different consonant inventory.
 By 24 months 
  • Initial Sounds – /p, b, m, t, n, d, h, k, g/
  • Final Sounds – /p, m, n/
  • Produces Most Vowel Sounds Correctly and at least 6-8 different consonant sounds.
 By 28 months 
  • Initial Sounds  /d, f,  and y/
  • Final Sounds – /s, d, k, f/ and n /
 By 32 months 
  • Initial Sounds – /w/
  • Final Sounds? - /t, b, r/
 By 36 months 
  • Initial Sounds – /s/
  • Final Sounds – /l, g/ and /er/ endings
  • Child uses at least 9-12 different consonant sounds.
 By 40 months 
  • Initial Sounds – /l, r/
  • Some consonant blends  bl, br, tr
  • Final Sounds  /v/ and sh
 By 44 months 
  • Initial Sounds sh and ch and fl
  • Final Sounds ch
 By 48 months 
  • Initial  sp, st, kl
 After 48 months 
  • Initial – /z, v/ and j and th
  • Final – /z/ and th and j
For most children, the list of phonemes will be all you need to determine if speech therapy is appropriate for your child. However, the following red flags are incredibly important and require immediate attention as they may signal more serious articulation or medical concerns. Again, the following list was taken from teachmetotalk.com.
Numerous Vowel Errors – Most children have mastered nearly all vowel sounds by age 2. Some errors are still acceptable are age 2, but by age 3, all vowels be mastered (with exception of /r/ vowels).
Widespread Deletion of Initial Consonants-  By 2 a child should use at least 3 to 4 different consonant sounds at the beginnings of words.  By 3 a child should have a large repertoire of initial consonants.
Substitution of Back Consonants /k/ and /g/ or /h/ for a variety of Consonants-  This is atypical phonological development and should be targeted even in very young children.
Deletion of Final Consonants after age 3- By 24 months in language delayed children some final consonant deletions are expected, but by 36 months, all children should be producing words with ending consonant sounds. 
What can I do? 
If, after reading these lists, you have decided that your child does indeed require consultation or assessment to get into speech therapy, here are some great activities you as a parent can do:
  • Choose one sound they are having difficulty with, then read a book with your child and emphasize that sound. Have them repeat those words back to you.
  •  Find objects out of the car window that start with your child's sound and point them out. Make it a game to find objects that start with their target sound.
  •  Use playdough and make the letters for the child's target sound. You could also create playdough sculptures of objects with that sound. Another fun variation would be to draw with sidewalk chalk or with your fingers in flour.
  •  Download articulation apps on your tablet or phone and have the child play. I enjoy abcmouse.com letter videos or youtube videos from "Have Fun Teaching" which review many speech sounds. The "Have Fun Teaching" videos are especially great for "auditory bombardment" (having the child listen to the sound over and over again) and are really fun to sing and dance along to.
  • Use tangible and intangible positive reinforcement when practicing. When your child pronounces their target sound correctly tell them "Good job!" or "What a great sounding /s/!" Give hugs, high fives, or fist pounds to help them know they are doing a good job. You could also set up a chart that for every 10 sounds they say correctly they get M&Ms or a healthy snack they love. Make speech fun!
  • Ask your speech therapist. Your speech therapist may have word lists, resources for free activities, and advice on where to start with your child. 
 My advice is its always better to be safe than sorry as far as speech therapy is concerned. If you looked at these lists and still have concerns please consult with a Speech Pathologist and get screened or assessed to see if those concerns are appropriate. Early intervention is the best intervention and outcomes for children who receive Speech therapy earlier rather than later are fantastic. Those children with early speech therapy are in speech for less time and typically have significantly better results.
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Articulation Therapy Approaches

Articulation Therapy Approaches

Articulation is the technical term for how people pronounce words. Many children and adults have no difficulty pronouncing words according to their accent. Sometimes though, children may have difficulty developing appropriate articulation, some adults may have difficulties remaining from childhood, and other adults may lose their articulation abilities thanks to a stroke, traumatic brain injury, or other medical difficulty. Speech therapy focusing on articulation is one way of addressing these difficulties. 

There are a wide range of techniques that are used by Speech Language Pathologists all over the world, however I wanted to review some of the most popular here. Traditional Articulation Therapy using minimal pairs, the Cycles Approach, and the Whole Language Approach are very different, however they contain some similar principles and all focus on treating articulation. 

Traditional Articulation Therapy
According to Van Riper (a very famous researcher) in 1978, "The hallmark of traditional therapy lies in its sequence of activities for: (1) identifying the standard sound, (2) discriminating it from its error through scanning and comparing, (3) varying and correcting the various productions until it is produced correctly, and finally, (4) strengthening and stabilizing it in all contexts and speaking situations." 

Essentially Traditional Therapy has the child identify the sound, identify the sound from the error sound (for example if they say /sh/ for /s/ the clinician would have them listen to various words and tell her/him which started with the correct /s/ sound) , correct their production through various exercises, and then expand those exercises. 

During traditional therapy, minimal pairs- pairs of words like "sheep" and "seep" or "ship" and "sip"- are often utilized to work on identifying the sound and distinguish the sound from error. Many believe that a child may be hearing a word incorrectly leading to incorrect pronunciation, so traditional therapy focuses on correcting that understanding. Typically in traditional therapy you might start with the single sound, then a syllable, then words and words in pairs, then phrases, sentences, and finally conversation.

For more information about Traditional Articulation Therapy visit

Cycles Approach
Formally known as the Cycles Phonological Pattern Approach (CPPA) was created by a researcher named Hodson to help extremely unintelligible children. It is based on the theory that children gradually learn phonological (sound) patterns as they learn to speak. For example, first children may learn early syllable structures like /baba/, then they will learn back sounds like /k/ and /g/, then /s/, etc.  Some children may have difficulty learning those patterns so they either don't develop the pattern at all or they develop different patterns (for example saying /th/ instead of /s/). The Cycles Approach uses groups of "cycles" of patterns to teach children new patterns of speech depending on their need.

An example Cycles Approach may look something like this
  • Week 1- work on pronouncing multiple syllables (for children who only use one syllable). For example, getting a child to say "i-un" for "Chicken" is an improvement upon just "un"
  • Week 2- work on producing final consonants. The final consonants would depend on the child, but for example, if a child does not produce final /d/ or final /t/ ("da" instead of "dad" or "pa" instead of "pat") those may be the targeted sounds.
  • Week 3- work on producing /s/ clusters (such as /sp/, /sl/, /st/, etc.). 
One hour of therapy time would be spent on each week's lesson and then the entire cycle would be repeated. Typically, children require 2-4 cycles to master those goals and then the cycles would move toward more difficult goals, eliminating goals mastered, and repeating goals they continue to have difficulty with.

For more information about the Cycles Phonological Pattern Approach visit
Whole Language Approach
Many children experience both articulation difficulties and language difficulties. The Whole Language Approach attempts to address articulation through language-based activities. For example, while reading a book, the clinician may emphasize certain shttps://www.blogger.com/blogger.g?blogID=3577234683978949925#editor/target=post;postID=723103093311687439;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=0;src=postnameounds while reading. The clinician may then have the child retell the story and incorporate cues, minimal pairs, or multiple repetitions to assist the child articulate correctly in a more naturalistic language setting.

For more information about the Whole Language Approach visit
Conclusion
The American Speech Language Hearing Association (ASHA) does not recommend one approach over another as each client is different, however they do emphasize that articulation therapy is effective.  There are multiple additional approaches to therapy and combinations of therapy approaches which can assist those who have articulation difficulties. At Jessica Washer Speech Therapy, we strive to utilize Evidence Based Practice- a combination of research, clinical judgement, and client values- when treating clients for the most effective therapy possible.  Our hope is that every client is able to be dismissed from therapy having met their goals and achieving their best speech and language abilities.

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