articulation

Why Did My Child Qualify For Articulation Therapy?

by
Woman holding the letter S with child imitating a touch cue in speech therapy
Bowl of pastel colored alphabet letters

ARTICULATION

Why is understanding the journey of speech sound development crucial, and what is the basis for evaluation and treatment in articulation therapy? Making progress in speech development starts with understanding the evaluation and treatment process for articulation delays, as discussed in this post.

In this comprehensive guide, we will navigate the journey of speech sound development and discuss the basis for evaluation and treatment in articulation therapy. Understanding the milestones and stages of speech sound acquisition is crucial for identifying potential delays and designing effective intervention plans. Articulation therapy, distinct from phonological and childhood apraxia of speech therapies, targets specific speech sound errors to enhance clarity and pronunciation. We’ll explore the various assessment methods used to evaluate speech sound production and discuss evidence-based treatment approaches.

Additionally, we’ll highlight the pivotal role of home programming in reinforcing therapeutic gains and supporting speech progress beyond the therapy room. Join us as we navigate through the fundamentals of speech therapy and empower caregivers with practical strategies for facilitating speech development in children.

Milestones and the Evaluation Process:

Speech pathologists assess speech sound development using a test battery containing all consonant sound targets. Most of the time, a child with an articulation delay can produce vowels accurately, but not consonant sounds.  If your child hasn’t mastered age-expected sounds, their score may indicate therapy is necessary. The chart pictured below is my all-time favorite speech development reference tool from 1972 for parents.  I particularly like how it displays the wide range for development of each sound target.

Speech Sound Development Chart

Some children need more time to master sounds with any number of factors influencing that timeline. Ear infections, fluid buildup, wax, growth, attention issues can delay sound mastery for months or years in some children.

In 2018, McLeod and Crowe published a study updating developmental expectations for speech sound development. Note that these researchers suggest that all speech sounds are acquired by six years. Under these guidelines, more children may qualify for speech services.

McLeod-Crowe-2018-English-consonants-Treehouse-A4

After the Evaluation:

You just learned that your child is eligible for speech services due to an articulation delay.  If you are in early intervention, then you likely will not see specific sound targets in your treatment plan, but that all changes in an IEP- Individualized Education Plan.

Let’s walk through the meetings that lead to an IEP in the school system. First, attend a brief referral meeting at the school to determine testing needs with the team. A couple months later, you will reconvene and review all test results.  If your child qualifies for speech, then you will create an IEP at that eligibility meeting.  Listen carefully to the goals for speech articulation, which are written to be met in one year.  Given that these goals must be achieved in a year, they should be concise, measurable, and appropriate for your child’s age.

Here is an example of an achievable objective, focusing on an early sound production: Increase accuracy of /b/ in all positions (i.e., ball, cowboy, web) of words with 85% accuracy.

Here is an example of a lofty goal which should be divided into smaller components as there are 18 objectives in this one example: Increase accuracy of /p, m, h, n, w, b/ in all positions at the word level with 85% accuracy.

In summary, you have the right to ask questions during any meeting, be it for eligibility or treatment planning. If goals seem unattainable, express concerns during IEP meetings. Parents are one of the most important team members because you know your child best!

Therapy:

Woman holding the letter S with child imitating a touch cue in speech therapy

Your child needs articulation therapy when he substitutes or distorts one or more sounds.  For example, he may substitute the /w/ for /r/ in the word rabbit or distort the /l/ in the word ladybug such that the /l/ does not sound clear and crisp. In articulation therapy, we teach lip and/or tongue placement for target sounds. Here, we progress from isolated sounds to sentences and practice sounds in all word positions: initial, medial, and final. So, someone working on the /s/ sound may practice “sun”, “glasses”, and “cats.”  Typically, we look at mastery in one position before moving onto another.  We target developmentally appropriate sounds and increase the level as the child progresses.

Homework:

Your speech pathologist will want your child to practice sound targets at home once progress is noted in treatment sessions. Waiting for accuracy is crucial; clients who practice at home generalize skills, reducing therapy time and ensuring error-free practice.

Conclusion

In summary, understanding speech sound development lays the foundation for effective evaluation and treatment of articulation disorders. By incorporating home programming into therapy plans, caregivers can play a crucial role in reinforcing progress outside of sessions. Consistent practice in natural environments enhances therapy outcomes and promotes long-term speech proficiency.

Important Caregiver Information about Speech Buddies

by
Close up image of Rabbit Speech Buddy for R

Over the last three decades, I have witnessed that some children benefit from feeling where to place their tongues to successfully produce target sounds, particularly those who have made little progress with traditional articulation therapy. A tactile approach has proven effective in unlocking articulation breakthroughs for children who have struggled with conventional therapy methods.

Speech Buddies

Complete Speech Buddy Kit displayed with iPad lesson plan

One tool that I have used with moderate success is Speech Buddies. These tools are the size and length of a tongue depressor that individually target: L, R, S, CH, and SH sounds by helping a child identify correct placement of the tongue to accurately produce that sound.  Here is how you introduce and use this product:

  1. I always begin with letting the child hold and feel the flexible tool before placing it in his mouth.
  2. Next, we talk about where his teeth and tongue should be positioned on the tool using the images in the booklet that the company provides.
  3. I always hold the Speech Buddy at first to help the child feel the right placement, but I quickly give them independence as this helps make them feel more comfortable.
  4. We start with saying words that begin with the targeted speech sound with the Speech Buddy in the mouth, but I swiftly transition to saying the word with the Buddy and then without.  Removing the Speech Buddy provides a reset that supports programming the muscles to store a memory of proper movement. To teach the mouth muscles to recall the correct placement, the child needs to say the word with support, then without.
  5. Practicing with the Speech Buddy twice weekly for 20 minutes fosters muscle memory better than longer, once-a-week sessions.

Considerations Before Making a Purchase

Consult your speech pathologist before trialing any tool; it ensures suitability and maximizes investment effectiveness for parents. These tools are not appropriate for everyone for several reasons:

  1. They require a certain level of cognitive ability to follow directions.
  2. Some children need to develop better jaw support before working on tongue movements.
  3. Not every child can tolerate having a tool in his mouth due to oral sensitivity and/or hyperactive gag reflex.
  4. Your child may not require this type of feedback to learn how to produce /l, r, s, ch, sh/ sounds.  Verbal cues alone may suffice.
  5. These products are not a ‘stand alone’ option or replacement for skilled speech evaluation and therapy.

Pros

  • I’ve found great success with Speech Buddies for improving /s, sh, ch, l/ sounds, in both school and private practice.
  • Parents can easily help children generalize practice at home. The tool helps ensure accurate articulator placement occurs every time.

Cons

  • In truth, my success with the R Buddy has been limited. There are two options for producing R: retroflex and bunched.  The Speech Buddy only supports the retroflex option.
  • The retroflex R movement is not best for everyone. Some children, especially those with tongue ties have a hard time with retroflex R.
  • Mastering the retroflex movement with the R Speech Buddy poses a challenge as it requires unraveling the Buddy with the tongue tip.
  • Speech Buddies are costly and not covered by insurance

Costs

Individual Speech Buddy tools range from $99-$124 in price with a complete kit costing close to three hundred dollars.  Unless your child needs help with all the above-mentioned targets, you do not need to purchase a kit.  I would suspect that if he does require help with several sounds, then your speech pathologist may need to work on improving jaw stability first.

I aimed to educate on tactile feedback for articulation delays and suggest Speech Buddy tools.  A formal evaluation before any home program is necessary. These evaluations are crucial in identifying other medical reasons like hearing issues or tongue ties that impede therapy progress.  As frustrating as it is to wait for testing, it is well worth the time.

Verified by MonsterInsights