THERAPY FOR INDIVIDUAL
PHONEMES
Specific Techniques for Phonetic
Placement
National Institute on Deafness and Other
Communication Disorders, 2017:
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/**
• I like to refer to
these sounds with
animal analogies
• /s/ is the snake
sound, and /z/ is the
bee sound
Types of Lisps
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:**
• Close teeth, direct airstream through a straw
• Place finger at very center of teeth, attempt /s/
• Draw a small target; hold it in front of Ch’s
mouth; tell her to make a bull’s-eye with the /s/
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…
(Eddie)
/s/ is tough
with retainers,
but it is
possible! Got
226
productions!
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
(Teaching /l/ to my kids)
One of my very favorite
techniques…
Be sure…**
• The child is not rounding lips
• Have her smile
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…
Gleason & Ratner, 2017:
Ann Tyler ASHA:
Ann Tyler ASHA 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
(Crystal)
**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!!