What Does Articulation Therapy in the Schools Look Like?

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Articulation therapy in the schools may look very different than in a clinical setting. Although just part of the caseload, people think of it when people think of a speech therapist. Articulation is the making of the sounds of speech. The production of speech sounds means the coordination of the articulators. The articulators are the lips, tongue, teeth, palate (top of the mouth), lungs (respiratory system)

No two children develop the same and this is true when we are thinking of articulation. It appears as if some children come out of the womb being able to be very articulate. Then there are some children who take more time.

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When we talk about articulation and phonological disorders we are talking about children that do not have other motor or neurological structural abnormalities or sensory processing/perceptual disorders. Children with more complicated diagnoses have some more specific treatment protocols that need to be examined along with their difficulties in articulation (ex. apraxia).

Evaluation of Articulation in the Schools:

For articulation therapy in the school, I may get referrals from parents worried about their child’s speech or from the teacher with a similar concern.

We have a team meeting to discuss the problem and to determine if we need to do an evaluation. Families are an integral part of the team and are part of this decision process. At this meeting I explain the next steps including the three questions that I need to explore in my evaluation.

Is there a disabiity?
Is it impacted their education?
Is there a need for specialized instruction?

If an evaluation is agreed upon for articulation one of the things I do is to gather a case history especially about early language development, hearing, history of any medical difficulties including any ear infections, head trauma or medications.

I do what is called an oral peripheral evaluation in which I first look at the structure of the articulators then I look at their function. Some of what I have discovered in the schools doing this evaluation could be missing teeth that may impact the clarity of speech. Sometimes a child will have a device such as a palatal expanded which I would need to know if the problem only came after the device was placed.

When I do an evaluation to look at articulation I make sure that I am looking at sounds from multiple presentations. There are times that children are able to say a sound in isolation or in a single word but then in connected speech has much more difficulty.

Conversely, there are times that a child is able to say a sound but there may be one particular word that they began to say incorrectly and have persisted beyond a time when they have been able to say the sound in other words.

What is great about articulation therapy in the schools is that I usually will also visit the child’s classroom to determine how the child is understood by the teacher and his peers in the classroom. Does the child raise his hand to answer questions? Is the child able to get his point across to his teachers? Does the child’s peers interact and understand the child.

Once all the diagnostic information is gatherered a report is written and the team meets to review the information. Again all the team members have input into answering the question as to whether the child is eligible for special education.

There are times that a student may have some articulation difficulties but it is not impacting them in school. For example a child may have some r controlled vowel distortions but they talk and are understood in the classroom and school community and are doing well in school subjects. If this is the case the parent will be given some names of places to get private therapy as well as some helpful hints as to how they can help their child. For some of these children I may do a round of Response to Intervention (RTI) to determine if can give the child some hints.

Those children who is determined that they do have an articulation disorder and that disorder is impacting them at school and requires specialized treatment this is recorded. A meeting is scheduled to develop an IEP which is a treatment plan . Articulation therapy in the school has very specific timelines that need to be followed.

Treatment of Articulation in the Schools:

I have worked in the field of speech and language pathology since 1979. Since that time there have been a number of different therapeutic techniques that have evolved as the science of speech continue to evolve. Articuluation therapy in the schools has been responsive to the changing science.

What has evolved for me is the treatment referred to as 5 Minute Kids™ . This a program was developed by Susan Sexton for “delivering articulation services to students with speech sound disorders by scheduling short, individual drill sessions. Over the last 14 years, data has shown that this model is more effective than traditional group therapy in achieving speech and language goals” as stated on their website

I have found that my students have done extremely well using this method. It allows me to see them multiple times a week which gives them multiple opportunities to practice the sound. As it is an individual session they are not exposed to other children’s incorrect productions. The work is very focused which assists the student in knowing what we are doing so that they are also better able to complete homework activities. This methodology also provides minimum disruption to the child’s school day.

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Some of the tools I use in conjunction with this therapy are:

mirrors so that the child can see what their mouth is doing
amplifier so that they can can hear my productions and their own productions. I also do some auditory bombardment using stories to begin a new sound. I use the amplifier to have them hear the difference between minimum pairs.
videos that help demonstrate where the articulators are
token towers that help the child see how many productions they have articulated
worksheets: I always do one worksheet that I then give for homework. This assures that I know if the child is able to do it as I want them practicing the correct production and not an incorrect one or one that they are inconsistent with. I also write notes on this for the family to know what we did and how they can help. Some of these worksheets may be games so that the child is motivated to do the work ( there is an incentive for turning homework in).
boom cards: I have loved using these that I discovered during COVID lock-down. They allow me to create materials specific to the child. As they are an online program I can add audiotory information.