By: Jessica F. Gantman, MS, CCC-SLP
You are about to begin articulation therapy with your child and we bet that you have questions! We are here to answer those questions for you, and to put your mind at ease.
Articulation Therapy FAQs
Below are our most popular queries regarding articulation therapy.
How long will it take?
The short answer is that it varies. There are many factors to consider, including how many sounds need remediating, frequency of therapy (once, twice, or even three times weekly), consistency of home practice, and motivation.
Why do you want my child to come twice a week?
In its simplest form, articulation therapy is changing a habit and muscle memory. Consistency is key when trying to make a change, and therapy twice weekly keeps that goal at the forefront of your child’s (and your) mind. We understand that life gets crazy, but twice-weekly sessions allow therapy to move quicker, and ultimately, get done faster with fewer overall sessions.
Please explain the hierarchy in which you do your therapy.
To remediate a misarticulated sound, your child must first hear and recognize a standard production of that sound to know what his or her target is. We first give your child significant exposure to the new sound. This is called auditory bombardment and we often do this type of therapy using something called minimal pairs. Minimal pairs are words that differ by only one sound. For example, your child substitutes /w/ for /r/. A list of words similar to this might be sent home for practice:
- Won run
- Right white
- Wag rag
- Wake rake
- Read weed
You would be asked to read these words aloud one pair at a time while placing a hand in front of (not covering) your mouth. Your child would either point to the picture that corresponds to the word or say when they heard the /r/ sound first or second. Once they can identify the target sound, we can move towards standard production.
Production in Isolation/Syllables
We group these two steps together because we want to move our clients into functional words as soon as possible. We work at the isolation level (only the sound) until a child can correctly achieve that production and then we immediately move to syllables.
All positions of words
The next step in our articulation hierarchy is at the word level. Let’s say we are targeting the /s/ sound. We would begin therapy with words such as “sand”, “sun” or “circle” and as therapists, we classify this word set as “/s/ in initial position of words.” We practice the target sound while providing models and appropriate cuing, then fading those supports to achieve at least 80% accuracy. We then move on to /s/ in medial (“messy” “pencil” “motorcycle”) and final (“bus”, class, “circus”) positions of words. Ultimately, we start addressing the sound in the position that is easiest and most functional for the child, so the order that word positions are targeted in varies depending on the child’s needs.
Phrases (2-3 words) /Sentences (4+ words)
Once mastery at the word level is achieved, we then move to producing the target sound in connected speech (with other words). This is done in the same manner as the word level, starting with phrases and then moving to short sentences. For example, “in the sand” and “I played in the sand.”
Reading (if applicable)
Reading tasks require the client to self-monitor their sounds and rate of speech as we do not provide an immediate model. If increased cuing is still required, we can underline or highlight the target sound within a piece of reading material.
This is the last step in our hierarchy. Our goal is better than 90-95% accuracy without any modeling or prompting. At this point in the game, clients should have generalized their sound(s) across different communication partners and environments. When we have achieved this, our client has successfully completed their course of therapy.
Does every child follow the same therapy framework?
Nope! A child may be able to produce /k/in the final position of words (“back”) but not in the initial position of words (“car”). We check stimulability for a target sound in initial, medial, and final positions of words and start with the position that is easiest for the client. Our goal is to meet our clients at their skill level and then scaffold from there.
Why does the goal say 80% accuracy and not 100%? Do you want my child to just sound “okay”?
The 80% mark indicates when to move on to the next position in words or from words to phrases to sentences. Our benchmark for completing therapy is better than 90-95% accuracy in spontaneous speech.
Why should I do the homework?
It is more difficult to change a habit when you only work on it at most, 90 minutes (2 sessions) per week. Practicing daily on the days when you do not come to therapy fosters consistency and improves overall remediation time. It really helps when a child can see the difference they are working so hard to make.
If you have a question about articulation therapy that wasn’t answered here, contact us! We’re happy to help!