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Accurate tests to assess hearing and recommend care.
Helping children and adults speak clearly and confidently.
Digital hearing aids fitted for your lifestyle and hearing loss.
From evaluation to AVT, we’re with you at every step.
Advanced hearing implant solutions for better clarity.
Consult online from the comfort of your home.
The term Articulation Disorder implies that the disorder has a motor component that affects the ability to clearly articulate specific sounds and syllables in words.
Articulation Therapy is a specialized type of speech therapy that helps individuals—most often children—learn to correctly produce specific speech sounds that they have difficulty with. These issues are usually due to articulation disorders, which occur when a person cannot physically produce certain sounds correctly.
Articulation disorders often involve substitutions, omissions, distortions, or additions of sounds. For example:
Saying "wabbit" instead of "rabbit" (substitution of /w/ for /r/)
Leaving out the /k/ sound in “cat” (saying "at")
The most commonly used technique to address speech sounds is what is called the “Traditional Articulation Hierarchy.” Individual sounds are first taught and then practiced in short utterances gradually moving to longer utterances and spontaneous speech. The 7 levels are:
1. Isolation:
First, the client is taught to produce the sound on its own. Depending on the sound, this can take a short amount of time or longer for harder to produce sounds. The SLP will have a bag of tricks to elicit speech sounds using anything from verbal prompts about tongue placement and airflow to tactile cues for reinforcement of tongue and jaw position such as a lollipop or tongue depressor.
2. Syllables:
After the client can produce the sound, it’s time to start pairing the consonant with vowels to form syllables. Syllables are usually the target consonant + vowel (ex. “Sue”) or vowel + target consonant (ex. “Us”).
3. Words:
After syllables, target sounds are then practiced with real words. There are three-word positions to work through initial, medial, and final. This means that the target sound can occur at the beginning of a word (initial position), middle of a word (medial position), and end of a word (final position). Clients may have an easier time producing the target sound in one word position compared to the others. Therefore the word level is usually first addressed using block trials, meaning only one-word position is addressed at a time. Gradually the trials can become random so that all word positions are addressed at once. Another thing to consider at the word level is the number of syllables per word. It’s best to start with one-syllable words and gradually move to two and three-syllable words.
4. Sentences:
Generally, the isolation, syllable, and word levels are a lot of practice and drill and can sometimes take the longest time to master. Once the client has mastered these levels, it’s time to start working on the carryover of the target sound into utterances that gradually increase in length. The first place to start for carryover is at the sentence level, which consists of 1-2 words combined with one word that contains the target sound (2-3 words in total). To keep things simple, use a carrier phrase such as “my” or “I see” and have the client rotate through the target words. Sentences can also be a carrier sentence that the client repeats and rotates through the target word list or they can be unique and change for each target word.
5. Stories:
This is not a typical step in articulation therapy; however, I am including it because it is a good step to use with older children (middle and high school). You can have older children write their stories and add as many of the specific sounds as possible. Have them read the stories aloud and ask them to repeat any words that they didn’t say clearly or accurately.
6. Conversation:
The last and final step into mastering a target sound is to practice spontaneous speech or conversation. Up until now, the client may be showing steady progress as the other levels are structured. It’s normal to see a little regression in sound production when first beginning this level. This level can sometimes take a while since the client is building a new habit to replace their old one of incorrect sound production in conversation in the home, school, and social settings.
7. Generalization
Generalization is the last step in articulation therapy! Once your child has mastered the sound(s) at the word, sentence, and conversation levels, they are ready to move over to generalization. This step is where you ensure your child is speaking clearly and articulately across all areas (e.g. at the playground, at the movies, in the car). If not, the therapist may choose to scale back to the conversation or sentence level!
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