Better Speech And Hearing Month

We are so excited that today is the start of May, which is Better Speech and Hearing month! Over the next month you can expect to hear more from us than usual, multiple new blog posts each week, tons of new resources, and even … Amber’s first blog post! And with that, let’s get right back to it with a continuation of our series on articulation!

We have already made it to part four of this series, and today we are going to be talking about the general outline of how we can begin to treat these speech sound disorders in therapy.

Therapy is typically structured in the following manner:

1. Isolation – This is where the therapist is trying to get the child to say the sound, all by itself. For example, if we are working on a “s” sound, we would be making the “SSSSSS” sound all alone and trying to get the child to be able to do this consistently before we move onto the next level.
2. Syllable – This is where the therapist is trying to get the child to say the sound in combination with a vowel. For example, if we are working on the “s” sound again, we might try it with the vowel at the end and practice “see” or we might try the vowel at the beginning and say “ess” as in the letter name.
3. Word – This is where the therapist can advance to helping the child to put the new sound into functional words.Typically (depending on the sound that the therapist is targeting, we start in the beginning of words, work our way to the middle of words, and then finally work on the sound at the end of words.
   1. Initial – This would be in the beginning of words such as “Sun” or “Sandle”.
   2. Medial – This would be in the middle of words like “grasshopper” or “messy”.
   3. Final – This would be in the end of words like “bus” or “pants”.
4. Phrase – This is where the therapist is beginning to add more length and complexity to the sound that the child is working on, so we might add one to two words. Example: “my soup”, “the red Santa”, etc.
5. Sentence – This is how we continue to make the phrases longer and mimic more natural speech. Example: “I wash dishes in the sink”, “I like my purse”.
6. Reading – If the child is able to read, reading allows the child to be able to see many of their target sounds in the words before they produce the word. It also allows therapist to structure the reading with a certain amount of the target sound into the passage. Reading aloud while working on their best sounds can be a fun motivator for some kids.
7. Structured Speech – This advances the level of the child to be able to produce all the correct sounds, but during unknown/unpredictable situations. This could be something as simple as “I want you to tell me about what you ate today using all your best sounds”, or some kids love to play “would you rather”, “what would you do if” or “truth or dare”. The main point is that it is longer than just one single sentence, but also a clearly defined activity for the child to work on their sounds.
8. Conversation – This would be having a conversation with the child while they are in the therapy session using all of their best sounds. This is challenging because the child needs to recall all of the times that they are saying their target sound, and the structure is becoming less clear while the time that they must perform lengthens.
9. Carryover – Carryover is the most challenging part of articulation instruction for therapists, and it can also be known as “generalization”. This is where the child incorporates all of their sounds that they have been practicing in speech therapy into their everyday speech all the time.

So as you can see, it is quite a process to get a child to add a new sound into their conversational speech all the time. Sometimes therapy can jump around, and a therapist may not need to hit each and every step in this sequence. But for the most part this is how it goes. Later this week we will take a look at what a therapist might do if they were to teach sound combinations instead of just individual sounds!

-Kasey-