|Tips for Articulation Placement/Production
By Dawn M. Moore MA, CCC/SLP
Nonsense Sheets: I typically use them for most sounds at the beginning. I use one page per sound (i.e., a whole sheet of ‘ray’ can be done in one session and then ‘ree’ in the next session and so on.) Each sheet has 80 productions on it, so that’s a lot of practice at the beginning with each long vowel. I do not use the nonsense sheets after we have moved onto Webber’s Book.
I highly recommend that you use a mirror and a flashlight during articulation therapy, especially for /r/. You will have much more success if you implement these simple tools into your therapy.
I spend most of my time with Webber’s Jumbo Artic Book (not for phonology though). I believe VERY strongly in drill and will drill each level (i.e., word, phrase, sentence) to 90% before moving on. That means repeating the same words each session. This is difficult for some people to want to do, but I have had great success in articulation therapy following the old principle that ‘practice makes perfect’. You can add a game, but do not let the game take away too much time from your therapy. You only have these kids for 30 minutes and if there are 3 kids in a group, each kid only gets 10 minutes of your time. Pass the Pigs is a great short game you can do at the end for 5 minutes and the kids LOVE it.
/R/ (Order: Ray, Ree, Rye, Row, Roo, Initial, Final, Medial)
Note: See my /r/ program for full details on remediating /r/
There are so many techniques for getting correct placement for /r/. The one that has always worked for me is using the nonsense words and having the child smile when they say the word “ray”. You need to tell the child they need to only use their tongue to make /r/. They will need to elevate their tongue (not flip it back), flatten it out and touch the sides of it against the upper side teeth. This will need to be done with a mirror, flashlight, tongue depressor (to show where the sides of the tongue are), and LOTS of cues. Some children can automatically do it, but others will need a lot of placement work. Sometimes it helps to have them lay on the floor so their tongue naturally falls into place for /r/. See the /r/ therapy page for additional information and how to work on vocalic /r/. For stubborn /r/ problems, the retroflex /r/ is also a possibility. It just depends on the child.
“SH” (Order: Nonsense Sheets-add final ‘sh’ to words on the paper, Final, Initial, Medial)
Note: You may need to change the order, depending on the child. Sometimes initial ‘sh’ is easier. If that is the case, you would do the nonsense words shay, she, shy, show, shoe and then move onto Webber’s drill book)
This is a difficult sound because the child needs to elevate the sides of the tongue. This elevation is needed to create the midline furrow for the air to escape the middle of the mouth. Most children do not know how to do this automatically. I have had a lot of success with a tongue depressor. You put it in the middle of their tongue and tell them to try to raise the sides up while the depressor is on their tongue and to try to wrap the sides of their tongue around it. It helps to give them the awareness they need to elevate the sides. I practice this enough until they can elevate the sides on their own and I have had good success with 'sh' after that. You can even have them try to produce ‘sh’ with the tongue depressor in place. A few sessions of this is usually all that is needed to get them to produce a good ‘sh’ and then you can use the nonsense sheets from there (shay, she, shy, show, shoe).
“CH” (Order: Nonsense sheets, the easiest to produce, w)
I typically do not work on “ch” until “sh” is established. The reason for this being that “ch” is actually /t/ + “sh” which is why it is transcribed the way that it is. Some children can produce “ch” and not “sh”, but it is usually the other way around. If they have neither, I would try “sh” first, but you can try “ch” too because you never know what each individual child will be able to do. I usually teach “ch” by having them produce the /t/ and then a quick “sh” fading out the gap between them over time to have a true “ch”
/S/ (Order: Say, See, Sigh, So, Sue, Initial, Final, Medial)
For children that have difficulty for /s/, it is sometimes easier for them to produce /s/ with their tongue tip behind their bottom teeth (as I learned from my speech therapist in second grade when I had a frontal lisp), the teeth slightly apart, and the rest of the tongue pushed towards the roof of the mouth.
Lateral /S/ (Order: Final /t/ words, Final, Initial, Medial)
Lateral /s/ is one of the hardest sounds to remediate. You will need to spend a lot of time explaining to the child what they are doing (air is going out the sides) and what they need to be doing (air going out the middle). You can usually accomplish this by having them produce final /t/ words with you “letting the air of a tire”. DO NOT TELL THEM THEY ARE PRODUCING /S/. You tell them they are going to work on /t/ to help them get /s/. You can use the /t/ since it is a midline sound and then their tongue drops down behind the bottom teeth for /s/. You finger models. Tongue/finger up for /t/ behind top teeth and the finger/tongue drops as you let the “air out of the tire”. It may take a lot of work to get them to do this and you will need to give A LOT of feedback. Once they can produce the /t/ with good aspiration (an /s/ approximation) fade out the /t/ by throwing in some final /s/ words without a /t/ or final /ts/ words. Eventually drop the /t/ altogether after they have success in the final position, you can move on to initial and then medial. Some people have had success with straws having the child blow through them to correct the airflow. You can put a piece of paper in front of them to show if the airflow is correct. However, I have had more success with the first approach.
ALL OTHER LATERALS
You need to work on the correct placement for each individual sound. If they are lateralizing the “sh”, work on the above placement techniques for that sound. I typically target /s/ first as I have noticed that if they can fix /s/, many of the others are easier to get and some, especially ‘sh’ can fix itself.
NOTE: If you cannot correct the lateral sound no matter what you do, a dental referral may be in order to see if there is a structural problem with jaw alignment.
ANOTHER APPROACH: It was recommended on the message board to use a frontal lisp and actually teach a frontal to help remediate a lateral. I have used this with some success with kids where nothing else worked.
/F/ (Order: Add final /f/ to end of words on Nonsense Sheets, Final, Initial, Medial)
This is usually an easy sound to correct because of the visibility of teeth of on the lip. Make sure you tell them to blow air out across their lip when the teeth make contact. Use a mirror!!
/L/ (Order: Lay, Lee, Lie, Low, Loo, Initial, Medial)
I have not had to work specifically on /l/ a lot during therapy. I remember from graduate school that you are not supposed to work on final /l/ as it is not a true /l/, but syllabic /l/. I do think it is hard to work on in the final position. I do believe initial /l/ is the easiest to work on as you can have the child produce it with their tongue in between their teeth at the beginning (have them look in a mirror) so they get used to making it with their tongue and not their lips (i.e., /w/). Most of my kids have naturally moved their tongue back in their mouth for productions with my models, but /l/ can be made many different ways, so it will depend on the child. The rule of thumb that I use: Does it sound good? Even if the production is a little off and maybe the tongue is too far outside of the mouth, I ignore it if the sound is good. That goes the same for all sounds for me as well.
Tips for Phonology
The above is for traditional articulation drill ONLY! Ask for my Cycles outline. That is all I now use! You will waste a lot of time trying to remediate phonological errors with a traditional artic approach. I know this because I did it for years!!!!!! You can remediate a severe delay using Cycles in half (if not less) the time than you can trying to tackle one sound at a time. Cycles targets patterns and the carryover results are amazing. The best part is you only ever target WORDS, but you see generalization to conversation!!!!