Articulation Therapy

Speech Sound Therapy: ( articulation or phonological approach)

My philosophy and methodology for articulation have changed over time as new research and my own experiences began to shape how I provided treatment. Below is a list of some of the treatment approaches for articulation. In choosing an approach you need to consider the client’s age, severity, type of error and it’s impact on intelligibility.

Traditional Articulation Approach or Van Riper Approach: Articulation approaches target the error sounds with the aim of correcting the target sound. It includes auditory bombardment, sound in isolation, sound in syllables, words, phrases, sentences, reading, conversation. It starts with one sound usually looking at which sound is developmentally early or easier to produce.

Phonological approaches target a group of sounds that have the same error patterns (example: fronting which is saying tat for cat).

Cycles Approach: This technique may be considered if the student meets any of these characteristics:

• Highly unintelligible
• Frequently omit speech sounds
• Have few speech sounds

The student works on one process for several sessions but not necessarily to mastery and then the next process is worked on, hence the name cycle. You are cycling through the phonological processes.

Core Vocabulary Approach: In this approach, you are targeting whole words. This is often used for those students that the other approaches are not successful or for students who have been in speech therapy for a number of years and still have significant issues. You chose those words or phrases that the child uses and then you practice these until they are consistently produced.

Minimal Opposition Pairs Contrast Therapy: Contrast therapy uses pairs of words to contrast one sound to another ( won/run).  This uses four different contrast approaches, minimal opposition, maximal opposition, treatment of empty set, and multiple oppositions.

Entire World of R:  Specific articulation treatment approach which includes both a specific test and strategies for remediation of the /r/ sound. The test evaluates 944 /r/ words and gives specific strategies on choosing target sound.

Van Riper or Traditional Approach:

When I am using an articulation approach I always start with the sound in isolation to ensure that the child is able to produce the sound. Next, I put the sound in a syllable depending on the position I am working on. So for the /k/ sound in the initial position, I would say the following list with the vowels all long.

• ka
• Ke
• Ki
• Ko
• Ku

I would pay attention if there was one syllable that was most successful. I would point this out to the child so that they could hear it in themselves and then I would tell them one syllable that might be more difficult for the child.  I don’t move on from this until I have had some success.

For some of the children, I slow down the production of the sound to assist them in reaching the target movement.

Then I do the sound in words and follow the progression:

• isolation
• Syllable
• word
• phrase
• sentence
• reading
• conversation

In the schools, I am doing this with a drill type program seeing an articulation student in an individual session for a short period of time over a number of days and then always giving the student some home practice at a successful level. Seeing a child individually allows me to work more intensely with them and provides a greater number of repetitions. The child is also not hearing another student’s incorrect production. Typically I do syllable practice, word, phrase or sentence stimulus depending on where the child is at and I review the homework. I then use an app on the IPAD as my measurement or data collection for the session.

In the clinic, I supervise however the students are seen for 50 minutes which creates some difficulties as the graduate students are always looking for ways to make it interesting.

Some of the hints that I would give them is to:

• Ensure that you are getting many repetitions in the session.
• If you are using games or activities make sure it does not compromise the number of repetitions you are getting
• Make sure that the games or activities are directly related to the work you are doing and not as an ancillary activity as you will get more repetition and greater concentration on articulation if it is directly related to the game.

Here are some free ideas from around the web

• American Speech, Language and Hearing Association This is American Speech-Language and Hearing Association information describing treatment choices.
• Mommy Speech Therapy This is a great blog that breaks down the process well. She also has some free worksheets for the sounds. free worksheets
• Measured Mom’s free games with r controlled vowels Not made as an articulation game but can be used for one from The Measured Mom
• Articulation Cookie Game his is a great game for /k/ sound
• Articulation Puzzle for the /f/ sound
• Pinterest board for articulation
• Kuster’s ideas for articulation treatmentThis is a collection of activities.
• Comprehensive articulation manual
• Texas Articulation Manual
• Caroline Bowen website: many free assessments
• Intelligibility in Context Scale
• Phonological Awareness Resources
• Treatment of Speech Sound Disorder-13x1so3

• How to Choose a Therapy Approach for Speech Sounds: Articulation, Phonology, Cycles, Core Word

What have you found as great ideas for articulation?