Speech therapy tricks

2010-02-09T09:13:00.001-08:00

Therapy Facts and Tricks
FOR SPEECH-LANGUAGE PATHOLOGISTS
evidence-based strategies to enhance outcomes

Certified Speech-Language Pathologists are invited to use these free materials when working with children with speech sound disorders. You may save them to your computer and to customize them to suit individual clients and to fit your service delivery model. Just one request: whether you use them "as is", or in modified form, please acknowledge the author’s original work by leaving any copyright notices intact.

Voiceless Fricatives:
Aspiration Trick
FOR STOPPING and PRE-VOCALIC VOICING

EXPLANATION
STOPPING
Children for whom the phonological pattern (phonological process) Stopping of Fricatives is a problem are often easily stimulable for the voiceless fricatives /f/, /s/ and 'sh' in isolation. But, when they attempt to combine them with vowels in CV and CVC combinations many of them will insert a stop (usually /p/, /b/, /t/ or /d/ between the fricative and the vowel. So they have errors like "stoo" for "Sue", "sdoo" for "Sue", "shtip" for "ship", "shdip" for "ship", "fpin" for "fin" or "fbin" for "fin", and so on.
PRE-VOCALIC (CONTEXT SENSITIVE) VOICING
Children, with the phonological process pre-vocalic voicing replace /f/, /s/ and 'sh' with their voiced cognates, so that "fine" sounds like "vine", "sun" sounds like "zun" and sheep sounds like "zheep".

The "aspiration trick" can be a successful way of tackling these two difficulties. Here's an example of what to do:

STOPPING

1. Use some of the /h/ SIWI words (see hit, hat, horse, etc
below) for listening and production activities in order to
prepare ("prime"!) the child for what is to come.

2. Then choose about 5 each of the /f/, /s/ and 'sh' pictures and words. For example, select: f-heat-feet, f-hold-fold, f-heel-feel, f-horse-force, f-hound-found; s-hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce; and sh-heap-sheep, sh-hoe-show, sh-head-shed, sh-high-shy, sh-hop-shop. Practise saying f..., s..., and sh.... in isolation, and practise saying the /h/ words: heat, hold, heel, horse, hip, hope, hum, horse, heap, hoe, head, high, hop-shop.

3. Have the child listen while you say, "f-heat-feet, f-hold-fold, f-heel-feel, f-horse-force, f-hound-found; s-hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce; sh-heap-sheep, sh-hoe-show, sh-head-shed, sh-high-shy, sh-hop-shop".

4. Have the child repeat after you, "f...heat, f...hold, f...heel, f...horse, f...hound; s...hip, s...heel, s...hope, s...hum, s...horse; s...hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce; sh-heap, sh-hoe, sh-head, sh-high, sh-hop-shop.

5. Gradually shape the words from "f...heat" to "feet, s...hope" to "soap", and "sh...heap" to "sheep" etc., f...hold, f...heel, f...horse, f...hound; s...hip, s...heel, s...hope, s...hum, s...horse; s...hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce.

6. Then practise saying some of these:
f and s
s and sh
S...
f....

/h/ SIWI
hit, hat, horse, hot, heel, hound, hum, hill, heart, hawk, hair, heap, hold, hush, hand, hen, hop, hip, hive, hook, harm, hut, hymn, hug, high, hoe, hose, hoop, hold, hole, hear, hope, horn, hide, hurt, house, half, hiss, heat, hump, hang, hog, hop, height, hippopotamus, holiday, Halloween, Himalayas, hairdresser, hydrogen, handkerchief, harmonica, horrible, headmaster, headmistress, headquarters, hexagon, helicopter, hilarious, honeycomb, hollyhock, hospital, housekeeper, horseradish, horticulture, hydrangea, housewarming, Humpty Dumpty

The /f/ Aspiration Trick
f-heat-feet, f-hold-fold, f-heel-feel, f-horse-force, f-hound-found, f-height-fight, f-hat-fat, f-hit-fit, f-hair-fair, f-hive-five, f-harm-farm, f-hawk-fork, f-hang-fang, f-hog-fog, f-hill-fill, f-home-foam, f-hole-foal, f-horn-fawn

The /s/ Aspiration Trick
s-hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce, s-hole-sole, s-hand-sand, s-hoe-sew, s-hoop-soup, s-high-sigh, s-heat-seat, s-hit-sit, s-hat-sat, s-hound-sound, s-hold-sold, s-head-said, s-horn-sawn, s-hide-side, s-hay-say

The "sh" Aspiration Trick
sh-heap-sheep, sh-hoe-show, sh-head-shed, sh-high-shy, sh-hop-shop, sh-hip-ship, sh-hut-shut, sh-hook-shook, sh-horn-shawn, sh-hurt-shirt, sh-heat-sheet, sh-hair-share

Voiceless Stops:
Aspiration Trick
FOR PRE-VOCALIC VOICING

PRE-VOCALIC VOICING

1. Use some of the /h/ SIWI words (see hit, hat, horse, etc
below) for listening and production activities in order to
prepare ("prime"!) the child for what is to come.

2. Then choose about 5 each of the /p/, /t/ and /k/ pictures and words. For example, select: p-hip-pip, p-heel-peel, p-heap-peep, p-hair-pear, p-hug-pug; t-hip-tip, t-hawk-talk, t-heart-tart, t-hail-tail, t-height-tight; and k-hat-cat, k-hot-cot, k-hook-cook, k-heart-cart, k-hold-cold. Practise saying /p/, /t/ and /k/ in isolation, and practise saying the /h/ words: hip, heel, hug, hip-tip, hawk, heart, hail-tail, height, hat, hot, hook, heart, hold.

3. Have the child listen while you say, "p-hip-pip, p-heel-peel, p-heap-peep, p-hair-pear, p-hug-pug; t-hip-tip, t-hawk-talk, t-heart-tart, t-hail-tail, t-height-tight; and k-hat-cat, k-hot-cot, k-hook-cook, k-heart-cart, k-hold-cold."

4. Have the child repeat after you, "p-hip-pip, p-heel-peel, p-heap-peep, p-hair-pear, p-hug-pug; t-hip-tip, t-hawk-talk, t-heart-tart, t-hail-tail, t-height-tight; and k-hat-cat, k-hot-cot, k-hook-cook, k-heart-cart, k-hold-cold."

5. Gradually shape the words from "p-hip" to "pip", etc.

6. Then practise saying some of these:
/p/ SIWI
/t/ SIWI
/k/ SIWI

/p/ Aspiration Trick
p-hip-pip, p-heel-peel, p-heap-peep, p-hair-pear, p-hug-pug,
p-hole-pole, p-hat-pat, p-hop-pop, p-hen-pen, p-hot-pot,
p-high-pie, p-hawk-pork

/t/ Aspiration Trick
t-hip-tip, t-hawk-talk, t-heart-tart, t-hail-tail, t-height-tight,
t-hair-tear, t-hop-top, t-hoe-toe, t-hug-tug, t-hen-ten,
t-high-tie, t-heat-teat

/k/ Aspiration Trick
k-hat-cat, k-hot-cot, k-hook-cook, k-heart-cart, k-hold-cold,
k-hiss-kiss, k-hut-cut, k-hop-cop, k-height-kite, k-hole-coal,
k-home-comb, k-horn-corn, k-hawk-cork, k-hair-care

Backward Chaining
TRY IT!

EXPLANATION
Backward chaining is a technique that has been around for a long time, and it can be used to facilitate the production of two-syllable words in children who only produce monosyllables. What you do is have the child produce the second syllable first. For example:

To "get to" taking, making, waking (and other "king verbs"):

1. Elicit "king" and practise saying it a lot in games.

2. Practice saying tay, may, way briefly in a game, perhaps using a puppet.

3. The practice saying KING-tay- KING-may- KING-way, etc.

4. Switch them round the other way: tay-KING, may-KING, way-KING

5. Then "shift" the stress to get taking, making, waking, etc.

You can do the same with KEY-mong, KEY-duck, KEY-hang, etc.

Provide simultaneous models at first if necessary and then "fade" the model, Integral Stimulation style, Dynamic Temporal and Tactile Cueing (DTTC) if necessary.

CH Magic!
CHECK THIS OUT

EXPLANATION
Without being too precise (phoneticians of the world, don't jump on me!) the affricate "ch" comprises the voiceless alveolar stop /t/ followed by the voiceless palato-alveolar fricative 'sh'. For children who cannot produce "ch" facilitative contexts can be used in which a word with a final /t/ precedes a word with an initial 'sh', for example, "hat shop". There are pictures below SLPs can use to work with this idea.

"ch' SIWI and SFWF
chin, chick, choose, chip, chain, chop, chore, choo-choo, cheer, cheese, chair, chase, cheep, child, chewing gum, chalk, chimp, chews, chest, chart, cheers, chilli, cherry, champion, cherub, chisel, cello, children, chicken, chopsticks, China, chimney, chocolate, aitch, cockroach, spinach, coach, hatch, watch, beach, fetch, each, ouch, touch, crutch, pooch, pouch, hutch, witch, match, couch, itch, speech, reach, touch, teach, peach, stitch, scratch, rich, bench, wrench, branch, lunch, porch, torch, munch, perch, church, search, arch, march

"ch" Pictures and Words
One page of stimulus pictures, e.g., got you, ah-choo, ouch, cho-choo; and four pages of words and pictures of facilitative contexts for 'ch', e.g., hat shop - chop, neat ship -chip

"ch" Pictures and Words
...drill using facilitative contexts, e.g., wet sheep - cheep, cheep, cheep, cheep, cheep

"ch" Pictures and Words
...drill - three picture sequences, e.g., neat shirt, neat shirt, neat shirt

"ch" Stimulus Pictures

"ch" Magic Words!

...some of the the "ch" facilitative context word combinations without the pictures

Chaining
KEY...KING...

EXPLANATION
It is quite common among speech disordered populations to find children who can produce stops word finally (SFWF) and syllable finally within words (SFWW) but not word initially (SIWI) and at the beginnings of syllables within words (SIWW). This is particularly the case for /k/ and /g/. A variation of backward chaining can be used to address this difficulty. You use final velars that the child can produce to facilitate initial velars. For example, using the KEY WORDS you can elicit 'key' by rehearsing:

MONG-key
DONG-key
BLING-key
etc.

Then, gradually reduce the stress on the first syllable and "shift" it to the second syllable, making it more and more prominent.

mong-KEY
dong-KEY
bling_KEY
etc.

Moving at the child's pace, work towards just mouthing or cueing the first syllable (silently) so that the child is saying "key", on his/her own with a strong onset /k/.

You can do follow the same process with KING WORDS.

Follow this up with strings of:

key-Keith
key-keep
key-keys
key-keen
key-keel
key-quiche

and then introduce other vowels.

key à Keith
key à Keith, key à keen, key à keel, key à quiche,
keyà keys, keyà keep

The one-L lama,
He's a priest.
The two-L llama,
He's a beast.
And I will bet a silk pajama,
There isn't any three-L lllama!

la-la-llama
LOVELY LIQUIDS WITH LLAMA THERAPY

EXPLANATION
Children who have difficulty producing /l/ will often reach a point in therapy where they CAN say "la", but are unable to combine the /l/ with other vowels or diphthongs. The la-la-llama work sheets provide an opportunity to practice /l/ in a context that is comparatively easy, before moving on to /l/ SIWI in combination with other vowels. Try this:

la-la-llama, la-la-large ...
la-la...llama, la-la...large, la-la...laugh, la-la...latte,
la-la...laughing, la-la...lava, la-la...lama, la-la...lager,
la-la...Lana

Next, move on to other /l/ SIWI words.

/r/ trrrrreasure!
TRICK

EXPLANATION
In development, /r/ often emerges first in /tr/ clusters. This can be used in therapy to elicit /r/ SIWI. Practice and strengthen the accuracy of the client's production of /r/ in /tr/ SIWI words such as triangle, track, trash, tractor, etc.

/tr/ SIWI
triangle, track, trash, tractor, train, trick, trumpet, treasure, tree, truck, trolley, trap, trio, tray, trim, trophy, trip, tram, traffic, trailer, treat, trapeze, travel, tread, triplets, tricycle, try

Then use minimal pairs such as track-rack (see below) to
facilitate production of /r/ SIWI.

/tr/ vs. /r/
track rack, trash rash, train rain, trick Ric, trap wrap, tray ray, trim rim, trip rip, try rye, tram ram, true roo, tread red

Next, move on to other /r/ SIWI words.

Marked Properties
IMPLICATIONAL RELATIONSHIPS

EXPLANATION
Relationships don't always work out, and implicational relationships are no exception. It is worthwhile, however, to experiment with target selection based on the marked properties of phonemes.

Markedness is a concept from the study of the sound systems of all natural languages. A marked feature in a language implies the necessary presence of another feature – hence “implicational relationship”. For example, there are languages, like English, that have stops and fricatives. There are languages that have stops, but no fricatives. But no language has fricatives and no stops. This means that fricatives are a marked class of sounds because the presence of fricatives necessarily implies the presence of stops in a particular language (an implicational relationship between fricatives and stops).

FRICATIVES
are marked because they imply
STOPS

VOICELESS SOUNDS
are marked because they imply
VOICED SOUNDS

AFFRICATES
are marked because they imply
FRICATIVES

CLUSTERS
are marked because they imply
SINGLETONS

Some research suggests targeting MARKED consonants in order to facilitate the acquisition of unmarked ones, or more precisely, targeting marked PROPERTIES in order to facilitate acquisition of unmarked aspects of the system.

...on markedness.

As indicated above, clusters are marked. The most marked of the clusters are /fl/, /sl/ 'shr' and 'thr'. By targeting these clusters generalization may be more 'system wide'.

/fl/, /sl/ 'shr' and 'thr'

Single Words
flower fleece fleet flood float flip flag flash flat flute floor flour
flea flake flock fly flame flight flare phlox slaw sloop slam slow
slip slime slate sleep slide sleeve slug slum slope sling slouch
slob slice slurp sledge sleet sleigh slap slack sleek shriek shred
Shrek shrug shrimp shrink shrine shrike thrust thresh thrip throng
threat thrill thrive thrift throw throne through throb three thread
thrush throat
Near Minimal Pairs
lame flame, lie fly, lock flock, lip flip; fat flat, feet fleet,
four floor, fake flake; lamb slam, lime slime, late slate,
low slow, lip slip, leap sleep; sip slip, sore slaw, sew slow,
side slide

/fl/, /sl/ 'shr' and 'thr'
Minimal Pairs /fl/ vs. /sl/
fleet sleet, flip slip, flash slash, flag slag, flat slat, flaw slaw,
fly sly, flow slow, fling sling, flap slap
Near Minimal Pairs 'shr', 'thr' and /sl/
shred thread, shrill thrill, shrew through, shrug slug, shriek sleek
Triplets /s/ vs. /l/,/sl/; /f/ vs. /l/ vs. /fl/
sip lip slip, Sam lamb slam, sew low slow, soup loop sloop,
saw law slaw, fame lame flame, fake lake flake, fight light flight,
shed red shred
Near Minimal Pairs /f/ vs. /fl/, /l/ vs. /fl/
feet fleet, fake flake, fat flat, foe flow, lip flip, lie fly, lame flame,
lake flake, lock flock, light flight
Near Minimal Pairs /s/ vs. /sl/; /l/ vs. /sl/
sip slip, seat sleet, sing sling, sew slow, Sam slam, sum slum,
side slide, sob slob, saw slaw, soap slope, lap slap, loop sloop,
late slate, leave sleeve, leap sleep, lip slip, low slow, lamb slam,
lime slime, ledge sledge
Near Minimal Pairs fricative + /r/
rug shrug, shine shrine, red shred, shed shred, rush thrush,
rob throb, red thread, rust thrust, row throw, rip thrip

Target Selection
WHAT TO TREAT FIRST & WHY

EXPLANATION
When theoretically sound, and, if possible evidence-based criteria are applied to therapy target selection, outcomes can be enhanced. Go here for information from the recent literature and here for "older", but not necessarily superseded, target selection guidelines arising from 1970's-1990's research.

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Speech therapy tricks