THERAPY FOR INDIVIDUAL
PHONEMES
Specific Techniques for Phonetic Placement
I. TEACHING /K/ AND /G/**
• The dorsum of the tongue must raise to contact the soft palate and
form a seal which completely blocks the air stream
• The back of the tongue must suddenly pull away from the velum to
create a burst of air
Strategies for eliciting these phonemes:
• **Tell the child to hold his tongue against his lower teeth and hold
his hand in front of his mouth to feel the burst of air as he imitates
you—tell him to raise the back of his tongue
• Use a mirror, and have the client imitate you
• Use a tongue depressor to push the tongue upward and backward
in the oral cavity
• Hold a piece of tissue, paper, or a feather in front of your mouth to
demo aspiration.**
• Marshmallow crème on Ch’s soft palate--get crème with middle of
her tongue
Youtube video
• Janine Fisher
• Therapy targeting /k/ and /g/ sounds
II. TEACHING /S/ AND /Z/
Types of Lisps
• Type 1: the frontal lisp
Type 2: The interdental lisp
Type 3: the lateral lisp
However, we can…**
• Have the child strongly aspirate a /t/
• Use a bite block to stabilize production
• A bite block helps the jaw to not move around
• Have the child say /t t t t t t ssssss/
• Eventually you can get away from the bite block
Shape /s/ from words that end in /ts/ (like “boats” or “cats”)**
• Tell Ch to drop her tongue after she says /t/
• Try having the child strongly aspirate /t/ German affricate /ts/. Have the child
prolong second part of this affricate.
Try this yourself…**
• And notice that when you make a really strong /t/, your tongue tip
drops into perfect position for a predorsal /s/ 
• Tell the child that when her tongue drops down, hold it there and
produce an /s/
Other techniques for /s/ include:
To develop a central airstream:
Other techniques:**
• Tell the child to make a smile and hide his tongue
behind the white gate (teeth) while resting his
tongue along his upper back teeth
• Tell him to blow out a straight, fine stream of air
• Place your finger in the center of his lips/teeth for
an additional cue
Also…
III. TECHNIQUES FOR /l/**
• One of the most common errors in children is j/l (“I yike
that yamp.”). Gliding!!
• I like to tell kids about the “magic spot” (the alveolar
ridge)
• It is very important for kids to have perfect awareness of
the alveolar ridge and know exactly where their tongue is
to be placed
One of my very favorite techniques…
Be sure…
Other tx ideas for /l/:
Use the ribbon technique **
• Place a ½” ribbon across the front of the client’s
tongue so that the ends hang down to her chin.
• Then, tell her to put her tongue tip on her alveolar
ridge.
• Have her say /l/ while you gently pull down on the
sides of the ribbon, which allows lateral airflow.
I do like…**
• Using /t, d, n/ as coarticulatory contexts
• E.g., ch can say na-la, na-la or da-la, da-la
IV. TECHNIQUES FOR /θ/**
• One of the very most common errors is f/θ
• Mark did this until he had artic therapy in first grade
• His SLP called /θ/ a “lip cooler” (could also be called tongue cooler or
angry goose sound)
To teach /th/ production:
I have found that…**
• Many adult accent clients are not comfortable with
their tongue protruding
• They feel like the whole world is staring at them
• I do a lot of desensitization and do the exercises in
the mirror along with them
• The mirror is super helpful, because they can see
that they do not look like idiots
If the client sticks her tongue out too
far…**
• Hold a tongue depressor about ¼” in front of her teeth
• If she can feel the tongue depressor when she produces /th/, her
tongue is coming out too far
/θ/ can be shaped from several
phonemes:**
• /h/ technique—have client prolong /h/, slowly stick her tongue out
while gradually closing her mouth
• Good: /θ/ and /h/ are both voiceless fricatives
To direct airflow through the oral
cavity:**
• Place straw where tongue tip contacts upper and lower front teeth, have
client direct air into straw
• Put client’s finger in front of his lips, have him repeat procedure by himself
• Hold a strip of paper in front of client’s mouth, near tongue tip, ask him to
blow out air to make paper move
•V. I Hate /r/!
A. INTRODUCTION—ORAL MOTOR
EXERCISES**
• Remediating /r/ is one of the most frustrating jobs that
SLPs have
• It is a very complex sound that requires precision and
muscle strength
• The use of oral motor techniques for helping clients with
/r/ problems is hotly debated
• Some say that there is no research to support the efficacy
of oral motor exercises—this is true
However…**
• Clinically, I and many of my friends in the profession
have found them to be extremely beneficial
• I have a hypothesis that because so many children
were bottle fed and/or used pacifiers, tongue
strength did not develop adequately
• Remember, for a baby, nursing requires far more
work than drinking from a bottle!
There are many oral motor exercises…
Other fun oral motor exercises…**
• Put cake sprinkle at corner of Ch’s mouth, have her move her tongue
laterally to get it
• Ch can stick her tongue forward and lick cake gel off of a tongue depressor
• Squeeze soft cheese or frosting on her hard palate, have her lick it off
One SLP I know…**
• Tells all parents of her /r/ kids that all liquids have to be drunk through
a straw—beginning today!
• NO MORE SIPPY CUPS
• One child had pudding races with her little brother
Have the client practice:**
• /k-k-k-k-k/ as fast as possible
Then, prolong /k/ (/g/ works too)
• Use /ng/--e.g. “thinggggrace”or “thingggrock”
A really good youtube video:**
• Making the "R" Sound Pt1. Gene Burger
Excellent /r/ video
• Speech Therapy for /r/
• Using Techniques from the entire world of /r/
• sayitrightspeech
B. /r/ WITH SMALL CHILDREN**
• Hodson believes that we can begin working on /r/ when children are
as young as 3 or 4
• With these little ones, we don’t drill to precision —but we “get it on
their radar”
How do we do this with young kids?**
• I like to get them a stuffed tiger and
talk about the growling tiger sound
• I ask the family to put the tiger in a
prominent spot and talk about the
/r/ regularly
For example, when they are reading books with their
children…**
• Point out /r/
• “Oh, there is your special tiger sound!”
• I ask parents to model correct /r/
productions regularly
• BUT…do not push the child too hard to
produce it
C. SPECIFIC TECHNIQUES
It is best to start each session…
Ann Tyler ASHA 2015:
Tyler ASHA 2015 continued:
We can use classroom textbooks for
metaphohological awareness…Helps us link
with classroom curriculum
We need to be sure…**
• Children are sitting up straight with their feet on the floor
• Their bodies need to be stable
It is very important…
• I like shaping /r/ from /i/--”eeeeeeeerrrr”**
• Helpful to smile; can’t make a /w/
• **A great technique is from PROMPT—the SLP puts her fist under
the client’s chin and pushes upward—this elevates the tongue
• We can use a tongue depressor to push the client’s tongue back in
her mouth
**The biggest thing with /r/…
• Is PRACTICE
• /r/ is hard; strong lingual muscles are needed
If the client doesn’t practice, no progress!
**Remember that the foundation of all
articulation therapy is:
• PRACTICE
• Retraining the muscles
• Repetitions!!