PROCESS OF ARTICULATION THERAPY

there are many other factors that affect speech

intelligibility such as hearing loss, apraxia, oral motor
deficits, sensory issues, and phonological processes
to name a few, but it will not be addressing any of
these here. This post is intended to simply explain the
basic structure of articulation therapy and how you
can work with your child on their sounds.
So, lets get started! The very first thing I want to
know as a Speech Language Pathologist is what
sounds does the child have difficulty with. As a parent
you could probably list them without a problem. If
you do need some help you may want to see a
speech pathologist and they can help you identify
them. They can do an articulation assessment that
will tell you exactly what sounds your child is
struggling with, what position of the word (begining,
middle or ending) they are struggling with it in, and
what sound if any they are substituting it with. They
can also tell how your child compares to other
children their age. So, after I have outlined the
problem sounds I like to check for stimulability.
Stimulability
What is stimulability? A child is stimulable if he or
she can say the sound in direct imitation of the
therapist or parent. If the child is stimulable or can
say the sound then you have cause to celebrate. That
means your job is going to be so much easier! If the
child cannot say the sound, youll have some work to
do. Youll need to teach them how to say the sound.
This is called sound elicitation.
Sound Elicitation
Sound elicitation is the process you go through to
teach the child how to say the targeted sound. For
example, if a child cannot say the /th/ sound in
imitation you break down the process for them. You
might say, Put your tongue between your teeth then
blow. After the sound is learned, meaning they can
say it accurately in imitation of you then practice the
sound in isolation.
1, Sound in Isolation
Practicing a sound in isolation means saying the
sound all by itself without adding a vowel. For
example, if you are practicing the /t/ sound you
would practice saying /t/, /t/, /t/ multiple times in a
row. The more accurate repetitions you are able to
get your child to produce the better. I am satisfied
with 10 accurate repetitions in a row. When you are
satisfied they can say the sound in isolation you are
ready to move on to syllables.
2. Sound in Syllables
Practicing a sound in syllables simply means adding
each vowel after the target sound, before the target
sound, and before and after the target sound, being
sure to practice the long and short form of each
vowel,
3. Sound in Words
At this point you have decided which position of the
word you want to target and will begin practicing
word cards in the initial, medial or final position of the
word. I am satisfied with 80% accurate independent
productions before I move on to the next step, which
is using the word in a sentence. Meaning, I dont
count it as correct if the child says it in imitation of
me. If I have to model a word for a child I will often
put that word card back in the rotation for them to
say again. After all the cards have been said we go
back and practice the word cards that were in error.
There are so many ways to make practicing word
cards fun. I sometimes make a snake and put a little
incentive such as an m&m or a fish cracker every 3-5
cards. I have also fed the cards to puppets after they
have been said, hid them around the room and gone
on a hunt to look for them, as well as played
memory, go fish and other fun card games. Be
creative this makes it more fun for both of you!
4. Sound in Sentences
My favorite way to practice sounds in sentences is
with a rotating sentence. In a rotating sentence
only the word card changes. For example, your
sentence might read, Put ________ in pink purse.
Then you rotate all your practice cards through the
sentence. This is an especially great way to practice
sentences for young children who cant read yet.
They are able to memorize the sentence, or use
visual cues to help them read it aloud. You are also
able to maximize the production of your target sound
when you use a sentence with two or three target
words in it. You may find my sentences for the
different sounds on the worksheets page.
With older children, I have them write their own
sentences using their target words. When a child has
articulated 16/20 or 80% correct I have them move
to stories.
Fifth.Sound in Stories
Practicing the sound in stories is not a step that is
typically recommended. In fact it is more common to
move straight from sentences to conversation. I have
found that with the addition of this step I have more
success moving the sound into conversation.
For my younger children I like to prepare a story for
them to practice using the sound cards they have
been practicing. You may use the stories I have
created on my worksheets page. I try to include as
many picture clues as I can so young children can
retell the story without being able to read.
I have asked older clients to write their own stories
using the word cards. They usually come up with very
creative stories that are very entertaining for both of
us.
After the child has mastered reading the story aloud
with 80% accuracy I have them retell me the story
without reading it. This is just another small step
toward getting an accurate production of the target
sound in conversation. Once they can do this I move
them to conversation.
Sixth Sound in Conversation
In the therapy setting this step can be a little more
tricky. I like to use a conversation jar. I have
probably 200+ questions in my conversation jar that
get my clients talking and telling me all about
themselves. It also gives me a more controlled
environment where I can track their progress in
conversation. You may also consider centering
conversation topics around some of the target words
they have mastered. However you decide to do it be
sure to set a specified time to focus on the correct
production of the target sound during conversation.
Be sure to correct any inaccurate productions of the
target sound at this time.
7. Generalization
Once the sound has been mastered in words,
sentences, stories and in conversation you want to
watch for generalization across all the contexts of
language. If the child you are working with seems to
be having difficulty generalizing the target sound go
back and practice the words, sentences and stories
again until they are able to produce the sound
correctly in daily speech.
A quick review First practice the sound in isolation,
then in syllables, words, sentences, stories,
conversation and finally generalizing the target sound
in all contexts of language. When this pattern is
followed the child has a greater likelihood of success.
The only thing that changes in this process is how to
elicit the different sounds. This basic pattern of how
to teach the sounds remains the same.
I hope this will give you a good starting point in
working with the misarticulations in your childs
speech. Remember to be patient, and to make it fun!