Articulation Disorders
An articulation disorder involves difficulties producing specific speech sounds, usually consonants. This may be characterized by a child producing the “w” for “r” (wabbit for rabbit) or a child with a lisp.
Other times, children may have difficulties with entire sound categories and/or processes, and as a result produce a greater number of errors which significantly impairs their ability to be understood by familiar and unfamiliar listeners alike. This is sometimes given a more specific diagnosis known as a phonological disorder. Children with phonological disorders are at an increased risk for difficulties acquiring literacy skills once they are in school.
MY APPROACH
My treatment for articulation disorders involves teaching correct sound postures, modeling, and moving through a hierarchy of practice from working at the sound level, moving to placement of the targeted sound within words, and eventually generalizing the new, correct sound into a child’s conversational speech.
Articulation disorders frequently require LOTS and LOTS of practice both in and outside of treatment sessions. You are basically training your brain a new skill and just like learning to play a sport or instrument, practice makes perfect! My treatment of articulation, especially phonological disorders heavily focuses not only on sound production, but awareness of the sound being made. Since research has shown a link between articulation and literacy skill acquisition, you may see me implement lots of literacy activities into our sessions which I think sets me apart from many other SLPs.
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Apraxia of Speech
This is another kind of articulation disorder, but this type of disorder is actually known as a motor-speech problem. Children with Apraxia of Speech know what they want to say, but have difficulties getting the parts of their mouth to move in the correct manner to say words.
This disorder is not the result of a muscle weakness, but due to a breakdown between their brain and their articulators. These children make errors on not only consonant sounds, but vowels, too. Sounds are often distorted in a different manner each time so the same word may sound different when it is repeated. These children may have an easier time saying shorter words and may also be better at saying rote/memorized information, like singing “happy birthday”.
MY APPROACH
Treatment often involves a significant amount of practice building up a child’s sound repertoire (as these children may have only a few sounds they can accurately produce), and moving through a hierarchy of simple-complex word structures. Mass practice is key.
One of my go-to approaches for working on apraxia of speech is known as Dynamic Temporal and Tactile Cueing (DTTC). With this, multi-sensory cues are used to facilitate productions of words and phrases.
I may also ask families to write down a short list (2-3 items) containing functional words or very short phrases which includes primarily sounds the child can ALREADY produce. I love to focus on getting functional targets practiced first so that the child can feel most successful in their home/school. This frequently means we may practice saying a child’s sibling’s name, or perhaps practice saying “I need help” or “my turn” to help the child advocate even when it’s hard to get their words out.
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Fluency Disorders
This is frequently referred to as “stuttering” and is characterized by a disrupted flow of someone’s speech, such as repetition of sounds and words and frequent pauses in someone’s speech.
MY APPROACH
When I work with kids with fluency disorders, I love to provide education on typical and atypical disfluencies (because yes, we all get “stuck” sometimes), discuss myths surrounding stuttering, and provide strategies to improve the naturalness and flow of one’s speech. I believe in teaching inner acceptance in addition to direct techniques and tend to use an Acceptance and Commitment Therapy Approach (ACT) as many children with these types of disorders may struggle to feel confident which I’ve found to be one of the hardest aspects for parents to witness.
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