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Therapy Facts and Tricks
FOR SPEECH-LANGUAGE PATHOLOGISTS
evidence-based strategies to enhance outcomes
 
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Certified Speech-Language Pathologists are invited to use these free materials when working with children with speech sound disorders. You may save them to your computer and to customize them to suit individual clients and to fit your service delivery model. Just one request: whether you use them "as is", or in modified form, please acknowledge the author’s original work by leaving any copyright notices intact.

 

 

 

huh-huh-huh-huh-huh

Voiceless Fricatives:
Aspiration Trick

FOR STOPPING and PRE-VOCALIC VOICING

EXPLANATION
STOPPING
Children for whom the phonological pattern (phonological process) Stopping of Fricatives is a problem are often easily stimulable for the voiceless fricatives /f/, /s/ and 'sh' in isolation. But, when they attempt to combine them with vowels in CV and CVC combinations many of them will insert a stop (usually /p/, /b/, /t/ or /d/ between the fricative and the vowel. So they have errors like "stoo" for "Sue", "sdoo" for "Sue", "shtip" for "ship", "shdip" for "ship", "fpin" for "fin" or "fbin" for "fin", and so on.
PRE-VOCALIC (CONTEXT SENSITIVE) VOICING
Children, with the phonological process pre-vocalic voicing replace /f/, /s/ and 'sh' with their voiced cognates, so that "fine" sounds like "vine", "sun" sounds like "zun" and sheep sounds like "zheep".

The "aspiration trick" can be a successful way of tackling these two difficulties. Here's an example of what to do:

STOPPING

  1. Use some of the /h/ SIWI words (see hit, hat, horse, etc
    below) for listening and production activities in order to
    prepare ("prime"!) the child for what is to come.

  2. Then choose about 5 each of the /f/, /s/ and 'sh' pictures and words. For example, select: f-heat-feet, f-hold-fold, f-heel-feel, f-horse-force, f-hound-found; s-hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce; and sh-heap-sheep, sh-hoe-show, sh-head-shed, sh-high-shy, sh-hop-shop. Practise saying f..., s..., and sh.... in isolation, and practise saying the /h/ words: heat, hold, heel, horse, hip, hope, hum, horse, heap, hoe, head, high, hop-shop.

  3. Have the child listen while you say, "f-heat-feet, f-hold-fold, f-heel-feel, f-horse-force, f-hound-found; s-hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce; sh-heap-sheep, sh-hoe-show, sh-head-shed, sh-high-shy, sh-hop-shop".

  4. Have the child repeat after you, "f...heat, f...hold, f...heel, f...horse, f...hound; s...hip, s...heel, s...hope, s...hum, s...horse; s...hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce; sh-heap, sh-hoe, sh-head, sh-high, sh-hop-shop.

  5. Gradually shape the words from "f...heat" to "feet, s...hope" to "soap", and "sh...heap" to "sheep" etc., f...hold, f...heel, f...horse, f...hound; s...hip, s...heel, s...hope, s...hum, s...horse; s...hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce.

  6. Then practise saying some of these:
    f and s

    s and sh
    S...
    f....

3 pages
/h/ SIWI
CLICK HERE FOR PICTURES AND WORDS FOR
hit, hat, horse, hot, heel, hound, hum, hill, heart, hawk, hair, heap, hold, hush, hand, hen, hop, hip, hive, hook, harm, hut, hymn, hug, high, hoe, hose, hoop, hold, hole, hear, hope, horn, hide, hurt, house, half, hiss, heat, hump, hang, hog, hop, height,
hippopotamus, holiday, Halloween, Himalayas, hairdresser, hydrogen, handkerchief, harmonica, horrible, headmaster, headmistress, headquarters, hexagon, helicopter, hilarious, honeycomb, hollyhock, hospital, housekeeper, horseradish, horticulture, hydrangea, housewarming, Humpty Dumpty

1 page
The /f/ Aspiration Trick
CLICK HERE FOR WORDS AND PICTURES FOR
f-heat-feet, f-hold-fold, f-heel-feel, f-horse-force, f-hound-found, f-height-fight, f-hat-fat, f-hit-fit, f-hair-fair, f-hive-five, f-harm-farm, f-hawk-fork, f-hang-fang, f-hog-fog, f-hill-fill, f-home-foam,  f-hole-foal, f-horn-fawn

1 page
The /s/ Aspiration Trick
CLICK HERE FOR WORDS AND PICTURES FOR
s-hip-sip, s-heel-seal, s-hope-soap, s-hum-sum, s-horse-sauce, s-hole-sole, s-hand-sand, s-hoe-sew, s-hoop-soup, s-high-sigh, s-heat-seat, s-hit-sit, s-hat-sat, s-hound-sound, s-hold-sold, s-head-said, s-horn-sawn, s-hide-side, s-hay-say

1 page
The "sh" Aspiration Trick
CLICK HERE FOR WORDS AND PICTURES FOR
sh-heap-sheep, sh-hoe-show, sh-head-shed, sh-high-shy, sh-hop-shop, sh-hip-ship, sh-hut-shut, sh-hook-shook, sh-horn-shawn, sh-hurt-shirt, sh-heat-sheet, sh-hair-share

 


Voiceless Stops:
Aspiration Trick

FOR
PRE-VOCALIC VOICING

PRE-VOCALIC VOICING

  1. Use some of the /h/ SIWI words (see hit, hat, horse, etc
    below) for listening and production activities in order to
    prepare ("prime"!) the child for what is to come.

  2. Then choose about 5 each of the /p/, /t/ and /k/ pictures and words. For example, select: p-hip-pip, p-heel-peel, p-heap-peep, p-hair-pear, p-hug-pug; t-hip-tip, t-hawk-talk, t-heart-tart, t-hail-tail, t-height-tight; and k-hat-cat, k-hot-cot, k-hook-cook, k-heart-cart, k-hold-cold. Practise saying /p/, /t/ and /k/ in isolation, and practise saying the /h/ words: hip, heel, hug, hip-tip, hawk, heart, hail-tail, height, hat, hot, hook, heart, hold.

  3. Have the child listen while you say, "p-hip-pip, p-heel-peel, p-heap-peep, p-hair-pear, p-hug-pug; t-hip-tip, t-hawk-talk, t-heart-tart, t-hail-tail, t-height-tight; and k-hat-cat, k-hot-cot, k-hook-cook, k-heart-cart, k-hold-cold."

  4. Have the child repeat after you, "p-hip-pip, p-heel-peel, p-heap-peep, p-hair-pear, p-hug-pug; t-hip-tip, t-hawk-talk, t-heart-tart, t-hail-tail, t-height-tight; and k-hat-cat, k-hot-cot, k-hook-cook, k-heart-cart, k-hold-cold."

  5. Gradually shape the words from "p-hip" to "pip", etc.

  6. Then practise saying some of these:
    /p/ SIWI 
    /t/ SIWI
    /k/ SIWI

3 pages
/h/ SIWI
CLICK HERE FOR PICTURES AND WORDS FOR

hit, hat, horse, hot, heel, hound, hum, hill, heart, hawk, hair, heap, hold, hush, hand, hen, hop, hip, hive, hook, harm, hut, hymn, hug, high, hoe, hose, hoop, hold, hole, hear, hope, horn, hide, hurt, house, half, hiss, heat, hump, hang, hog, hop, height,
hippopotamus, holiday, Halloween, Himalayas, hairdresser, hydrogen, handkerchief, harmonica, horrible, headmaster, headmistress, headquarters, hexagon, helicopter, hilarious, honeycomb, hollyhock, hospital, housekeeper, horseradish, horticulture, hydrangea, housewarming, Humpty Dumpty

1 page
/p/ Aspiration Trick
CLICK HERE FOR PICTURES AND WORDS FOR
p-hip-pip, p-heel-peel, p-heap-peep, p-hair-pear, p-hug-pug,
p-hole-pole, p-hat-pat, p-hop-pop, p-hen-pen, p-hot-pot,
p-high-pie, p-hawk-pork

1 page
/t/ Aspiration Trick
CLICK HERE FOR PICTURES AND WORDS FOR
t-hip-tip, t-hawk-talk, t-heart-tart, t-hail-tail, t-height-tight,
t-hair-tear, t-hop-top, t-hoe-toe, t-hug-tug, t-hen-ten,
t-high-tie, t-heat-teat

1 page
/k/ Aspiration Trick
CLICK HERE FOR PICTURES AND WORDS FOR

k-hat-cat, k-hot-cot, k-hook-cook, k-heart-cart, k-hold-cold,
k-hiss-kiss, k-hut-cut, k-hop-cop, k-height-kite, k-hole-coal,
k-home-comb, k-horn-corn, k-hawk-cork, k-hair-care

 


Daisy Chains
 

Backward Chaining for /k/ SIWI
TRY IT!

EXPLANATION
Backward  chaining is a technique that has been around for a long time, and it can be used to facilitate the production of two-syllable words in children who only produce monosyllables. What you do is have the child produce the second syllable first. For example:

To "get to" taking, making, waking (and other "king verbs"):

  1. Elicit "king" and practise saying it a lot in games.

  2. Practice saying tay, may, way briefly in a game, perhaps using a puppet.

  3. The practice saying KING-tay- KING-may- KING-way, etc.

  4. Switch them round the other way: tay-KING, may-KING,  way-KING

  5. Then "shift" the stress to get taking, making, waking, etc., with the emphasis on the first syllable.

Provide simultaneous models at first if necessary and then "fade" the model, Integral Stimulation style, Dynamic Temporal and Tactile Cueing (DTTC) if necessary.

1 page
CLICK HERE FOR KING WORDS VERSION 1
1 page
CLICK HERE FOR KING WORDS VERSION 2

You can do the same with KEY-mong, KEY-duck, KEY-hang, etc.

1 page
CLICK HERE FOR KEY WORDS VERSION 1
1 page 
CLICK HERE FOR KEY WORDS VERSION 2

Backward Chaining for /n/ SIWI

(new)
1 page
CLICK HERE FOR KNEE WORDS
honey knee bunny knee funny knee money knee sunny knee
pony knee tiny knee beanie knee

Backward Chaining for /s/ SIWI

(new)
1 page
CLICK HERE FOR SEA WORDS
pussy sea messy sea bossy sea kissy sea Lucy sea fussy sea
juicy sea Nessie sea

Backward Chaining for /f/ SIWI

(new)
1 page
CLICK HERE FOR FI (FEE) WORDS
coffee Fi toffee Fi Daffy Fi stuffy Fi huffy Fi Miffy Fi puffy Fi trophy Fi

 


Got you!

 

CH Magic!
CHECK THIS OUT

EXPLANATION
Without being too precise (phoneticians of the world, don't jump on me!) the affricate "ch" comprises the voiceless alveolar stop /t/ followed by the voiceless palato-alveolar fricative 'sh'. For children who cannot produce "ch" facilitative contexts can be used in which a word with a final /t/ precedes a word with an initial 'sh', for example, "hat shop". There are pictures below SLPs can use to work with this idea.

3 pages
"ch' SIWI and SFWF
CLICK HERE FOR PICTURES AND WORDS FOR
chin, chick, choose, chip, chain, chop, chore, choo-choo, cheer, cheese, chair, chase, cheep, child, chewing gum, chalk, chimp, chews, chest, chart, cheers, chilli, cherry, champion, cherub, chisel, cello, children, chicken, chopsticks, China, chimney, chocolate, aitch, cockroach, spinach, coach, hatch, watch, beach, fetch, each, ouch, touch, crutch, pooch, pouch, hutch, witch, match, couch, itch, speech, reach, touch, teach, peach, stitch, scratch, rich, bench, wrench, branch, lunch, porch, torch, munch, perch, church, search, arch, march

5 pages
"ch" Pictures and Words
CLICK HERE FOR PICTURES AND WORDS FOR
One page of stimulus pictures, e.g., got you, ah-choo, ouch, cho-choo; and four pages of words and pictures of facilitative contexts for 'ch', e.g., hat shop - chop, neat ship -chip

7 pages
"ch" Pictures and Words
CLICK HERE FOR PICTURES AND WORDS FOR
...drill using facilitative contexts, e.g., wet sheep - cheep, cheep, cheep, cheep, cheep

2 pages
"ch" Pictures and Words
CLICK HERE FOR PICTURES AND WORDS FOR
...drill - three picture sequences, e.g., neat shirt, neat shirt, neat shirt

1 page
"ch" Stimulus Pictures
CLICK HERE FOR "ch" STIMULUS PICTURES

1 page
"ch" Magic Words!
CLICK HERE FOR WORD LISTS FOR
...some of the the "ch" facilitative context word combinations without the pictures

(new)
3 pages
Aspiration Trick
FOR "ch"
CLICK HERE FOR WORDS AND PICTURES FOR
ch-heap cheep, ch-high chai, ch-hook chook, ch-hip chip,
ch hawk chalk, ch-hop chop, ch-heart chart, ch-hair chair


Daisy Chains
 

Chaining
KEY...KING...

EXPLANATION
It is quite common among speech disordered populations to find children who can produce stops word finally (SFWF) and syllable finally within words (SFWW) but not word initially (SIWI) and at the beginnings of syllables within words (SIWW). This is particularly the case for /k/ and /g/. A variation of backward chaining can be used to address this difficulty. You use final velars that the child can produce to facilitate initial velars. For example, using the KEY WORDS you can elicit 'key' by rehearsing:

MONG-key
DONG-key
BLING-key
etc.

Then, gradually reduce the stress on the first syllable and "shift" it to the second syllable, making it more and more prominent.

mong-KEY
dong-KEY
bling-KEY
etc.

1 page
CLICK HERE FOR KEY WORDS VERSION 1
1 page 
CLICK HERE FOR KEY WORDS VERSION 2

Moving at the child's pace, work towards just mouthing or cueing the first syllable (silently) so that the child is saying "key",  on his/her own with a strong onset /k/.

You can do follow the same process with KING WORDS.

1 page
CLICK HERE FOR KING WORDS VERSION 1
1 page
CLICK HERE FOR KING WORDS VERSION 2

Follow this up with strings of:

key-Keith
key-keep
key-keys
key-keen
key-keel
key-quiche

and then introduce other vowels.

3 pages
key -- Keith

CLICK HERE FOR PICTURES AND WORDS FOR
key Keith, key keen, key keel, key quiche, key keys, key keep


llama

The one-L lama,
He's a priest.
The two-L llama,
He's a beast.
And I will bet a silk pajama,
There isn't any three-L lllama!

Ogden Nash (1902-1971)

la-la-llama
LOVELY LIQUIDS WITH LLAMA THERAPY

EXPLANATION
Children who have difficulty producing /l/ will often reach a point in therapy where they CAN say "la", but are unable to combine the /l/ with other vowels or diphthongs. The la-la-llama work sheets provide an opportunity to practice /l/ in a context that is comparatively easy, before moving on to /l/ SIWI in combination with other vowels. Try this:

Revised version November 2007
7 pages

la-la-llama, la-la-large ...
CLICK HERE FOR PICTURES AND WORDS FOR
la-la...llama, la-la...large, la-la...laugh, la-la...latte,
la-la...laughing, la-la...lava, la-la...lama, la-la...lager,
la-la...Lana

Next, move on to other /l/ SIWI words. There are pictures for this here under the heading "liquids".

Banana Splits The New Llama Song


/r/ trrrrreasure!
TRICK

EXPLANATION
In development, /r/ often emerges first in /tr/ clusters. This can be used in therapy to elicit /r/ SIWI. Practice and strengthen the accuracy of the client's production of /r/ in /tr/ SIWI words such as triangle, track, trash, tractor, etc.

2 pages
/tr/ SIWI
CLICK HERE FOR PICTURES AND WORDS FOR
triangle, track, trash, tractor, train, trick, trumpet, treasure, tree, truck, trolley, trap, trio, tray, trim, trophy, trip, tram, traffic, trailer, treat, trapeze, travel, tread, triplets, tricycle, try

Then use minimal pairs such as track-rack (see below) to
facilitate production of /r/ SIWI.

1 page
/tr/ vs. /r/
CLICK HERE FOR PICTURES AND WORDS FOR
track rack, trash rash, train rain, trick Ric, trap wrap, tray ray, trim rim, trip rip, try rye, tram ram, true roo, tread red

Next, move on to other /r/ SIWI words. There are pictures for this here under the heading "liquids".


Do you like my distinctive features?

Marked Properties
IMPLICATIONAL RELATIONSHIPS

EXPLANATION
Relationships don't always work out, and implicational relationships are no exception. It is worthwhile, however, to experiment with target selection based on the marked properties of phonemes.

Markedness is a concept from the study of the sound systems of all natural languages. A marked feature in a language implies the necessary presence of another feature – hence “implicational relationship”. For example, there are languages, like English, that have stops and fricatives. There are languages that have stops, but no fricatives. But no language has fricatives and no stops. This means that fricatives are a marked class of sounds because the presence of fricatives necessarily implies the presence of stops in a particular language (an implicational relationship between fricatives and stops).

FRICATIVES
are marked because they imply
STOPS

VOICELESS SOUNDS
are marked because they imply
VOICED SOUNDS

AFFRICATES
are marked because they imply
FRICATIVES

CLUSTERS
are marked because they imply
SINGLETONS

Some research suggests targeting MARKED consonants in order to facilitate the acquisition of unmarked ones, or more precisely, targeting marked PROPERTIES in order to facilitate acquisition of unmarked aspects of the system.

CLICK HERE FOR A 1-PAGE HANDOUT
...on markedness.

As indicated above, clusters are marked. The most marked of the clusters are /fl/, /sl/ 'shr' and 'thr'. By targeting these clusters generalization may be more 'system wide'.

6 pages
/fl/, /sl/ 'shr' and 'thr'
CLICK HERE FOR PICTURES AND WORDS FOR

Single Words
flower fleece fleet flood float flip flag flash flat flute floor flour
flea flake flock fly flame flight flare phlox slaw sloop slam slow
slip slime slate sleep slide sleeve slug slum slope sling slouch
slob slice slurp sledge sleet sleigh slap slack sleek shriek shred
Shrek shrug shrimp shrink shrine shrike thrust thresh thrip throng
threat thrill thrive thrift throw throne through throb three thread
thrush throat
Near Minimal Pairs
lame flame, lie fly, lock flock, lip flip; fat flat, feet fleet,
four floor, fake flake; lamb slam, lime slime, late slate,
low slow, lip slip, leap sleep; sip slip, sore slaw, sew slow,
side slide

8 pages
/fl/, /sl/ 'shr' and 'thr'
CLICK HERE FOR PICTURES AND WORDS FOR
Minimal Pairs /fl/ vs. /sl/
fleet sleet, flip slip, flash slash, flag slag, flat slat, flaw slaw,
fly sly, flow slow, fling sling, flap slap
Near Minimal Pairs 'shr', 'thr' and /sl/
shred thread, shrill thrill, shrew through, shrug slug, shriek sleek
Triplets /s/ vs. /l/,/sl/; /f/ vs. /l/ vs. /fl/
sip lip slip, Sam lamb slam, sew low slow, soup loop sloop,
saw law slaw, fame lame flame, fake lake flake, fight light flight,
shed red shred
Near Minimal Pairs /f/ vs. /fl/, /l/ vs. /fl/
feet fleet, fake flake, fat flat, foe flow, lip flip, lie fly, lame flame,
lake flake, lock flock, light flight
Near Minimal Pairs /s/ vs. /sl/; /l/ vs. /sl/
sip slip, seat sleet, sing sling, sew slow, Sam slam, sum slum,
side slide, sob slob, saw slaw, soap slope, lap slap, loop sloop,
late slate, leave sleeve, leap sleep, lip slip, low slow, lamb slam,
lime slime, ledge sledge
Near Minimal Pairs fricative + /r/
rug shrug, shine shrine, red shred, shed shred, rush thrush,
rob throb, red thread, rust thrust, row throw, rip thrip

 


Trochaic Sequences
CAMELRIDER, WATERMELON

EXPLANATION
When working on extending the number of syllables a child can say, or in working
on sequencing the syllables in polysyllabic words and word combinations, it can
be helpful to start with trochaic sequences. This is because there is a natural
tendency for children to find them easier to say. A trochaic foot, or trochee,
has a strong syllable followed by a weak syllable. In the following set of pictures
and words each image is associated with a a sequence of two trochees
(STRONG weak STRONG weak) like CAmelRIder (camel rider) and WAterMElon
(watermelon).

As the child grows in confidence and can say a good selection of trochaic words, gradually introduce new long words that are not trochaic, e.g., alphabet, America and dinosaur.

5 pages
Trochaic Sequences #1
CLICK HERE FOR WORDS AND PICTURES FOR
helicopter, locomotive, caterpillar, watermelon, kookaburra, motorcycle,
grand piano, alligator, mashed potato, Easter Bunny, creepy crawly,
cheeky monkey, clever puppy, birthday present, picking apples,
big banana, camel rider, ballerina, taxi driver, soccer player, under water,
hula dancer, television, Humpty Dumpty, finger painting, escalator

5 pages
Trochaic Sequences #2
CLICK HERE FOR WORDS AND PICTURES FOR
letterboxes, tiger lily, very windy, scary monster, service station, stripy tiger,
hungry kitty, cosy jacket, clever lady, aviator, tractor driver, unicycle,
shopping basket, stacking boxes, supermarket, calculator, shopping trolley,
nice tomatoes, laundry basket, rubber duckie, pillowcases, dictionary, competition, excavator, chocolate crackles, agapanthus, Persian carpet,
Cookie Monster, grand piano, tiny pencil

5 pages
Trochaic Sequences #3
CLICK HERE FOR WORDS AND PICTURES FOR
pencil sharpener, birthday candles, tape recorder, suit of armour, asthma puffer,
graduation, Viking helmet, Hello Kitty, pressure cooker, motor scooter,
airline pilot, ballroom dancing, table tennis, ten pin bowling, table tennis,
exercising, scuba diving, entertainer, ballerina, hula dancer, opera singer,
film director, portrait painter, carpet layer, fortune teller, respirator,
coffee maker, vacuum cleaner, concertina

5 pages
Trochaic Sequences #4
CLICK HERE FOR WORDS AND PICTURES FOR
ukulele, movie camera, tennis player, toilet paper, salad sandwich,
bunch of roses, fortune cookie, apple blossom, window cleaner, paper hanger,
teeter totter, vaccination, milk and cookies, bunch of daisies, station wagon,
music teacher, salad dressing, taxi driver,
glass of water, education,
swimming lesson, synthesizer, stormy weather, consultation, swimming teacher,
exclamation, animation, plastic bottle, four-leaf clover, end of freeway


Target Selection

Target Selection
WHAT TO TREAT FIRST & WHY

EXPLANATION
When theoretically sound, and, if possible evidence-based criteria are applied to therapy target selection, outcomes can be enhanced. Go here for information from the recent literature and here for "older", but not necessarily superseded, target selection guidelines arising from 1970's-1990's research.


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