She also worked as a clinical supervisor at San Diego State University's Communications Clinic for many years. A good home program is vital.Ĭarol Liddiard Buteau, MA CCC-SLP, is a speech-language pathologist who has worked at Kaiser Permanente Speech Pathology in San Diego for the last 25 years. As with any child, success also depends on how much the parents can help at home, following strategies what you have established in the therapy session.
Some children produce velars in the initial position easier, some in the final position. Once /k/ is produced, it can be facilitated in various word positions using phonological cards and games with these cards. Occasionally, the child has such difficulty that it may take weeks to get a semblance of a /k/. I have even had a child lay on his back on the floor and open his mouth, allowing gravity to help pull the tongue back. Often the tongue tip needs to be stabilized in a downward position with a tongue depressor or a sucker. I start by having the child put his head slightly back, open his mouth, and tap his neck, while modeling the /k/ sound for him. I use different visual and tactile cues depending on the child. Other children have no sense yet of "velarness" and the feeling of contact of the tongue on the back of the throat seems foreign to them. If the child produces a velar in ANY position you may be able to shape initial /k/ from there. I am assuming that the child doesn't produce /k/ in the initial position and that he fronts this as well. If /s/ is only a problem in the initial position (hissors) I would facilitate it there, using auditory and visual cues such as, "snake sound", or the gestural cue of my hand in sweeping motion like a snake's movement. In facilitating /f/, I use a lot of visual cues (showing the child my teeth on my lower lip ("chipmunk face"), asking him to try this using a mirror, using the "f" sign and pulling it away from my mouth to show a continuation of sound, etc.). In this case, maybe one session would be all that is needed to help him become aware of /f/ in the middle of words. If medial /f/ is the only position he is having trouble with, the sound may be emerging on its own. If he is able to produce /f/ in initial and final positions, I would simply start with medial /f/. If he is not producing /f/ in any position, I would start with initial /f/ and move to final, then medial. This is actually a fairly common substitution.
The child may be using a pattern substituting /h/ for more difficult phonological processes such as stridents (using your example of "telephone" and "scissors") or clusters ("drum"). I use Barbara Hodson's Assessment of Phonological Processes- Revised. I would first do a thorough investigation of all phonological processes if this hasn't already been accomplished.
Are there any techniques that could help correct this problem? Velar fronting is also an issue as well as Answer Examples: telehone (telephone), hissors (scissors), hum (drum), etc. Question I have a 4 year old patient who substitutes the /h/ phoneme for many consonants.
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