Re: Re: Articulation Therapy

[Guest guest]

Her delay is from impairment. The speech therapist described it as Audrey has

all the words in her head, but it's hard for her mouth to make those words.

When Audrey talks it is very deliberate and she works hard for each word to come

out. It's been getting better as she has words that she uses more regularly

than others.

Thank you for all this information.

[ ] Re: Articulation Therapy

Does Audrey have a diagnosis yet. I have your only other email below

from June of last year that says you were not sure if you should have

her evaluated. Articulation therapy would be great if Audrey has an

articulation delay or disorder. But...saying she's

getting " articulation therapy " can be a different approach from any

two school based SLPs. This is why you do need to know diagnosis

first. Is it just a delay or is it an impairmen?. If it's not

developmental and it's an impairment is it due to motor planning,

weakness, sensory -or is it 'just' an articulation or phonological

disorder..or something else?

If she has apraxia you need to have someone that knows about motor

planning or other appropriate therapies for apraxia because too much

articulation therapy sometimes causes dysfluencies.

Here's a bunch of " articulation therapy " ideas posted to one site

and more below -but get back to us when you can about diagnosis

Articulation Therapy Ideas

The following Articulation Therapy Ideas were posted to the mailing

list GRNDRNDS. Since it is a public mailing list, and does maintain

an archive, the ideas posted are not " copyrighted " and are available

to the public. To make it easier, I have extracted the ideas listed

by these creative clinicians. Perhaps they can adapted by clinicians

and student clinicians working with children with articulation

disorders and looking for therapy ideas.

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From Jackie

We play a lot of:

tic-tac- toe

putting the cards around a darkened room and then finding them with

flashlight (really a big hit with the preshcool set)

putting paper clips on each card and then pulling them off the table

with a magnet on a fishing pole

simple lotto games

simple board games

coloring target sound pictures

I also do a lot of giving a reinforcer for every two or three correct

responses as we go through the cards:

blocks

Connect Four game

monkeys from " Barrel of Monkeys

I also make a speech book and then staple the games onto the pages so

they can practice at home.

The main thing is to make sure that the playing of the game isn't so

involved that it gets in the way of trials.

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From:

Put and Take....

Cut construction paper into small squares, maybe 36...on an even

number of cards write, PUT 1, PUT 2, PUT 3, TAKE 1, TAKE 2, or TAKE

3. (you can color code the words for little ones who can't read) Give

each child 2 stacks of artic cards, one to be called a PUT stack,

another to be called the TAKE stack. Each child will turn over one of

your squares. If the card says PUT 2, child moves 2 cards from the

PUT stack over to the TAKE stack (after saying it correctly of

course). The object of the game is to empty one stack. It sounds more

complicated than it is. I think it's fun, easy to make and the gives

the children opportunity for drill.

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From: Carol

I do some easy craft activities with my little ones-things like

adding leaves to trees, or making it seasonal like pasting eyes, etc.

on a pumpkin. Often I hide the piece that they will paste under one

of two stimulus pictures and they have to choose which one--it puts

the stimulus word in a longer context, ie., " Is it under the___ " .

I also make my own puzzles-basically take a picture with their sound,

cut it into pieces and they put them back together. Then, we can talk

about the " snowman " or the " snowman's face " as they work on the

puzzle.

Other activities I do:

pasting pictures with their sound on seasonal pictures--they have to

ask for the picture they want.

bean bag toss-they name the picture they hit

riddles where the answer contains their target sound

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From Christiane

I pick anywhere from 4 - 10 target words for a half hour session,

draw pictures on a piece of paper, then drill the words with mirror

and all the little tricks (I also have a puppet with lips, teeth and

tongue, and have kids manipulate articulators on the puppet I got the

puppet - it remotely resembles a frog - at a rummage sale - it was

one of those with a big mouth like the muppet puppets, but it's not

Kermit. It had soft fabric around the mouth - voila lips. And then I

just sewed in a tongue and teeth out of felt. The teeth I

strengthened with Elmers glue - soaked the fabric and let it dry.) -

often combined with gross motor kind of movements, such as stamping

on the picture every time the kid says the word - in imitation or

spontaneous use. Then I move on to providing a frame for the word

(either sentence of phrase), with the kid filling in the word like in

a cloze test, e.g., it was time for bear to take his _____. Then we

use the words to draw, write and retell a story, with the child

participating depending on the linguistic level practiced. Variations

include using a story that I already have and having the child draw

and retell the story. Kids get to take their stories home and share

them with their family.

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From Sherry

I have a puppet called the " Speech Pillow " which I received as a

gift. It is a big round face made of fabric. It has removable lips

(they velcro on), teeth (not removable) & a big tongue which you or

your clients can put your hand in so you can manipulate the tongue.

It was a gift so I'm not sure exactly sure how much it was (maybe

around $30??)- Renfro Studios in Austin, Texas- 1-800-933-5512

to order- again, it's called the " Speech Pillow " . It's a great

puppet!

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From -Trish

I absolutely LOVE " Listening for Articulation All Year Round " by

Linguisystems. 1-800-PRO IDEA.

It's a great program for seasonal activities and it has games that

you can make by photocopying the masters from the manual. GREAT

STUFF!!!

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From

Get your hands on " Achieve for Phonology " by linguisystems. This has

lots of hands on activities for little ones and work sheets to use as

you drill with other students. I use crazy crayons and markers and

bright pens to spice up worksheets and this does busy the little ones

as you drill others. And as they sit they get the auditory

bombardment of the others responses.

I also use beanbags to toss on cards...and chips to place under

cards...and they LOVE money too. Soooooo many ideas I can't put them

all here. Write with any more questions at my address.

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From Jigna

Put cards in a bag. Have client close eyes, pick a card, and name it.

Bowling: clip cards on clothespins and line up (like bowling pins).

Have client roll ball and name the card he/she knocks down.

Hopping: place cards face down on floor (or under shaped cut-out

construction paper). Have client name the card he/she hops next to.

Mail cards: use a toy mail box and have client name each card as

he/she mails it.

Games: use any sporty games (e.g., basketball, football, baseball).

After each turn, have client pick a card and name it. If named

correctly, gets another turn.

Create a road with cards placed at various places on the board.

Client names the card he/she stops by.

For minimal contrasts:

memory

ask questions (e.g., if working on final consonant deletion): make a

stack of cards with final consonants and a stack without final

consonants. Pick a card from each stack and make up a question. For

example, " Can a moose go moo? "

present a minimal contrast pair and describe one from the pair. Have

client identify and pronounce the correct word. If correct, client

gets both cards.

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From Ursula

I make a spinner with the different parts the kids must collect to

create something (i.e., " r " rabbit, I have the ears, nose, whiskers,

etc.,.) and the children can spin and practice artic at the same time

(ex. " I need the rabbit's whiskers " ) Not only is it fun for artic but

you can also modify it for language, pragmatics or whatever!

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From Robin

I am one of those clinicians who has little fondness for games. I

prefer cooperative/interactive play, reading, writing and conversing.

As such early on in my career II used a homemade puppet...not as

sophisticated as your adapted one...to teach articulation. Now I just

do anything the child enjoys and interject the articulation therapy

as part of the activity. Sometimes with particularly challenged

children I will use a game as a distractor. At this point in my

career however, pretty much all I need is speech communication to

find the way to work on articulation. It may be just my way of saving

myself from something I never enjoyed even as a child,

namely " games " . I'd rather put on a play or paint or picture or read

a book to/with a child. Just how I am.

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From Celeste

I use a literature based therapy approach with almost all of my

students. For artic, I choose a book I like and think the students

will enjoy. I go through the book and make a list of all the words

containing the target sounds. I then make cards for these words. We

read and talk about the story. For older students, as we read each

page I let them find the words that have their sound. We use the

vocabulary cards to play games, (Memory, Go Fish, a board game, or

any activity you can think of). You can also ask questions about the

story and have the students respond with their target words. As you

can see, not only do you get lots of artic practice, but you can

target language and literacy as well. It helps link therapy with

classroom activities because it helps with word recognition and

reading skills. The students also like to take turns

playing " teacher " and " reading " the book to the group. I let them sit

in my chair and use my pointer as they read. Even though they may not

yet be able to read, they can retell the story in their own words.

I have found that using this approach to therapy rather than drill

increases carry-over. The students are practicing their speech in

more meaningful contexts. There is a book I love that I can't

remember the name of right now and it is at school. I think it is

Articu-lit. I know you can get it from Super Duper. It follows this

approach. Someone beat me to writing it!! Anyway, it has target words

for most of the sounds from about 25 popular children's books. It

also has blank vocabulary cards, and a game board to copy that goes

with each story. It also lists other activities as well as some

language activities for your language students. It's a great resource

to get you started.

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From

I use computer programs as the basis for artic therapy (once the

child can correctly produce the target sound in a word.) For older

artic students who can read, I use programs with simple repetitive

vocabulary (e.g, Oregon Trail from Learning Company, Carmen San Diego

USA by Broderbund, or Supermunchers from Learning Company) and have

them work on correct pronunciation for words with the sounds they are

working on. For non-readers, I can use Carmen Sandiego ,Jr. Detective

(by Broderbund) which requires no reading and I let the student name

the pictures with their sounds. Most kids love playing the

educational computer games. They are learning new vocabulary and new

facts as well as getting artic " drill " .

Another method I sometimes employ with readers is to have a child

make a computer picture with graphics containing his sound. Then we

write a colorful story together using these words. I usually use

Blocks in Motion with the Land, Sea, and Space module (Don ston),

but Kid Pix, KidWorks 2 or any other graphics programs should work.

The child has lots of opportunities to read back the story and share

it at home with family and with teachers.

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From

I love my little mailbox. I also use various containers that " eat "

chips. I have a frog with a slot on his head. A garbage can that open

with a mini footpeddal, etc...

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From Katy

From my perspective, there are two factors that have not been

directly addressed.

1. Regardless of the activity, articulation tx is much like physical

tx in that the specific motor behavior becomes automated only with

numerous trials. In other words, the number of attempts at production

must be substantial to change a motor behavior in a reasonable length

of time. I try not to have less that 50 responses in a 20 minute

session.

2. Because we do not spend much time talking in individual words, I

try to spend very little time at that level. Many of the activities

presented in response to this question stressed the production of

single words. I think we need activities which require sequenced

production. The sequences must ultimately be produced at a " normal "

rate of speed if the child is to use the target in spontaneous

communication. In other word, time spent on the phrase " my soup " (/s/

as target) should require /maisup/ rather than the separation of the

two words.

In my opinion, there is a great possibility that games will reduce

the efficacy of therapy by preventing the above emphasis. I simply

use tokens. I hold the number of tokens that I feel represents the

appropriate number of responses for the session. The tokens are

placed in a container following each response. When the tokens are

all in the container, the child gets a few minutes to " play " , pick

out a sticker, etc. If I find that I have selected more tokens than

are reasonable for that session I slip some into the container when

the child is not looking. In that way, the child always " finishes "

that which I have required. I have found that children soon learn

that the faster they go, the quicker they get to play. They never

figure out that I begin with more tokens as they get better.

Furthermore, because the " drill " has the potential to be boring even

though it is the most efficient way to change articulatory behavior,

the child is quite cooperative because he/she can " see " the contract

(tokens) at the beginning. In that way, the child senses some control

(getting rid of tokens quickly) and knows that I, as the adult, can't

make them engage in the drill indefinitely.

http://www.mnsu.edu/comdis/kuster2/therapy/articrx.html

Here's more on what you should be seeing between 2 and 3 and what is

cause for concern

Typically seen in first 18-24 months

· Uses mostly words to communicate · Begins to use two word

combinations (more cookie etc) · By 24 months has more than 50 words,

or word approximations

Cause for concern in first 18-24 months

· Relies on gestures to communicate · Limited vocabulary (speaks less

than 50 words)

· Does not use any two word combinations · Limited consonant

production · Mostly unintelligible speech · Regresses in language

development: Stops talking, repeats phrases inappropriately

Typically seen in first 24-36 months

· Engages in short dialogues · Expresses emotions · Begins using

language in imaginative ways · Begins providing descriptive details

when speaking · Begins to use articles and word endings (a, the,

ing,) uses plurals (cats)

Cause for concern in first 24-36 months

· Words limited to single syllable and no final consonants · Few or

no multiword utterances · Does not demand a response from a listener

· Asks no questions · Speech difficult to understand · Tantrums when

frustrated · Echoing of speech without communicative intent

http://www.cherab.org/information/latetalkerhandout.html

Let us know if you have a diagnosis -and for those that don't know

who you are again I've included your original message below:

New Member

Hello All,

I have a 17 month old daughter who has no real words as of yet. Her

pediatrician told me that if she wasn't saying 7 words by her 18 month

appointment that she would give me a referral for Early Intervention.

I'm

familiar with the whole process as my 5 year old began physical

therapy with EI

at 5 months of age for gross motor skill delays and sensory issues.

I'm on the

fence as to whether or not I should have my DD evaluated. One one

hand I think

she just needs a little more time, but I'm afraid that waiting to

give her help

might not be the best route to take? Is speech delay better addressed

as soon

as possible? My biggest concerns are that she says no real words

consistantly.

Every one in a great while she will say a new word but it's gone the

next day,

never to be said again. For 3 days she was calling DH, " daddo " but

then she

never used that word again. She said " mama " a long time ago, but only

once.

She does have a couple of made up words that she uses

daily, " bah gah " means all gone, " caca " is something yucky. That's

about it.

She understands everything that we say to her and will follow simple

directions.

She babbles like she is carrying on conversation but it's all just

different

variants of noises. Should I be concerned?

Marie (3.19.02)

Audrey (12.30.05)

Molly Anne (5.13.07)

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