speech pathologist - Lessons in Speech with Nanette

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, such as speech buddies, has proven effective in unlocking articulation breakthroughs for children who have struggled with conventional therapy methods.

What are Speech Buddies?

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:

I always begin with letting the child hold and feel the flexible tool before placing it in his mouth.
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.
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.
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.
Practicing with the Speech Buddy twice weekly for 20 minutes fosters muscle memory better than longer, once-a-week sessions.

Considerations Before Buying Speech Buddies

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:

They require a certain level of cognitive ability to follow directions.
Some children need to develop better jaw support before working on tongue movements.
Not every child can tolerate having a tool in his mouth due to oral sensitivity and/or hyperactive gag reflex.
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.
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.

Nanette

Nanette Cote is an ASHA certified speech pathologist, published author, and private practice business owner with 30 years experience.

As you navigate the landscape of speech teletherapy, it’s essential to narrow down your options to a few companies that align with your goals and values. Once you’ve identified them, thorough research is key. Delve into their websites, seek input from colleagues, and leverage social media platforms to gather insights before scheduling interviews. Now, let’s address some common queries about teletherapy.

How many hours a week do you work in speech teletherapy?

I have worked for two companies and both required I work directly with clients for at least ten hours weekly. Additionally, I receive compensation for time spent on billing, consulting with parents, writing IEPs, documenting, and planning sessions. I am compensated for late cancellations or no-shows. Typically, I bill 10-13 hours weekly for therapy and related tasks.

How many kids are on your caseload?

I have worked with children in virtual school settings, meaning that they are either home-schooled and/or participate in charter schools with fewer hours than traditional school settings. Therefore, I typically have 9-10 clients on my caseload of 10 direct hours weekly.

How often are you paid for speech teletherapy?

I submit my bills on the last day of each month and then receive a direct deposit two weeks after invoicing.

Do you need to find your own clients?

No, if you contract with a company, then they assign you clients. This was important for me when I first started in teletherapy. I knew I could do telepractice independently, but entering this new world, I preferred starting with a reputable company and relying on them for assignments.

How does speech teletherapy work?

Clients meet me in “my therapy room” by logging into a HIPPA-secured space. We both need to use a device (laptop, iPad, Chromebook) with a webcam to see each other.

In addition to facilitating activity loading and data collection during sessions, most platforms offer a variety of interactive tools for engaging therapy experiences. These include circling answers, playing games with stamps, utilizing timers, and accessing video content for diverse speech and language tasks. Clients consistently find these features motivating and engaging, making it difficult to conclude sessions.

Do you need to be certified in other states?

Yes, as of right now, I need certification in the state I reside in and that of the client’s. The companies that I have worked for reimburse me for certification and renewal fees for licensure in states where my clients reside.

What are your contracted rates?

I can’t discuss salary, but some companies negotiate fees more than others. As a contract therapist, I anticipated lower reimbursement rates. My goal was to fill daily gaps and ensure steady income. Thus far, my contracts have fit both of those bills.