LifeRs

Lifers

 

Did you ever have those clients that have been working on the /r/ sound for years?  We all have. You’ve tried placement using a tongue depressor, peanut butter, mirror, or anything else you can think of but you still get a distorted /r/ sound.  These students may have been working on this sound at 6, 7, 8 years of age.  By this time he is BORED as he has been working on the same thing and can’t get it right.

You know Albert Einstein’s definition of insanity right?

Insanity

It’s time to try a different approach.  You have nothing to lose.

So what can you try that you may not have already attempted? Why not try an oral motor approach?

While the efficacy of oral motor exercises is a controversial topic, all you have to gain is the chance at a correct /r/ production.  Have you done an extensive oral motor examination? Give it a shot!

You will likely find some weaknesses in the oral musculature impacting correct placement for /r/.  Focus on making these weak muscles stronger and getting the articulators in the correct placement and the odds are you will get better productions.

Remember that the oral motor strength and movements are NOT the goal of treatment. The production of the sounds and speech intelligibility are the ultimate goal!

Don’t be the definition of insanity…try something different.

What are some of your successful oral motor exercises for improved production of /r/?

For more information and interesting reading on the oral motor controversy, check out The Oral Motor Institute including monographs on the oral motor debate and a recent narrative review by Dr. Kay Kent.

 

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The ABCs of /s/ and /z/

Watermarked sz Photo (2016-06-16-1308)

We all know that there are various reports, research, and information regarding the age of acquisition of speech sounds. How in the world do we decide which ones to use for determining if a student has an articulation disorder? Are you at the mercy of your school system and the age norms they have decided to use?

We have searched many resources and found The Iowa Articulation Norms Project and its Nebraska Replication to be a very helpful read.

When it comes to /s z/, this article raises some great points. Believe it or not, the projects found that acquisition curves for /s z/ did not reach 90% criterion until age 9! Considering that these sounds are so common in English, do we really want to wait that long?

The researchers identified that 80% of responses were adequate by age 7 with slow growth after that. We love the recommendations they provide to look at /s z/ at age 7 with some additional considerations.

To wait or not to wait, that is the question

If a 7-year-old uses an acceptable production of /s z/ in any context (including clusters), it may be best to delay intervention. We should also consider if the child is stimulable for any acceptable production or if they are still waiting on those two front teeth for Christmas! Check again for these same factors at age 8 and again at age 9…but by then we should intervene for sure if errors in production (and educational impact) are still evident.

Speaking of educational impact…

Us school-based SLPs ALWAYS have to consider educational impact. More often than not, with articulation, this is especially evident in the social context. There can definitely be justification to start earlier based on documentation of impact on educational performance!

Too late for lateralizations?

Lateralized productions are not likely to improve with age without intervention. Therefore these should not be considered developmental errors. Early intervention can be considered (as early as preschool) given that the child demonstrates a response to treatment and does not appear to be improving on their own.

Our favorite reference: Smit, A. B., Hand, L., Freilinger, J. J., Bernthal, J. E. & Bird, A. (1990). The Iowa articulation norms project and its Nebraska replication. Journal of Speech and Hearing Disorders, 779-798

Elissa’s personal perspective

You know you’re an SLP mom when you shudder at your two year old’s dentalized /s z/. And you try SOOOO hard not to help her fix it! Then at age 3 it hasn’t changed AT ALL…what’s a mom to do?!?!

So you provide models, show her in the mirror where her tongue goes…

ID-100351320

She’s only 3!

By age 4 she is stimulable (mom breathes audible sigh of relief). Maybe she won’t need speech…

So now she’s 5 (5 ½ if you ask her) and ALL BY HERSELF she produces the most beautiful /s/ and /z/…well, most of the time. Sure she slips now and then but come on…she’s only 5!

It will all be ok!

What age norms do you utilize for /s z/?

Image courtesy of fantasista at FreeDigitalPhotos.net