I HATE r

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I HATE /r/!
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On the exam

• I am not distinguishing between techniques for
  the different kinds of /r/ (pre- and postvocalic)
• Remember that you dont need to read pp. 128-158
  after all ?

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I. INTRODUCTIONORAL 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 exercisesthis is true

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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!

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There are many oral motor exercises

• My personal favorite is to have the client, as
  often as possible, just quietly lift the middle
  and back of the tongue to the hard palate and
  hold it there, pressing hard
• They can do this anywhere ?
• Another good one is having the client push her
  tongue forward and press it against a tongue
  depressor

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Other fun oral motor exercises

• We can put a cake sprinkle at the corner of the
  childs mouth and have her move her tongue
  laterally to get it
• The child can stick her tongue forward and lick
  cake gel off of a tongue depressor
• We can also squeeze soft cheese or frosting on
  her hard palate and have her lick it off

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• The child can hold a paper straw or tongue
  depressor horizontally between her front molars
  and lift her tongue blade, bending the straw
• She can squeeze a cake sprinkle between her
  tongue and hard palate
• Sarah Rosenfeld-Johnson has her horns and straws
  programmes
• Drinking thick liquid out of a straw really works
  on tongue retraction
• Drinking pudding out of a straw is ideal

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One SLP I know

• Tells all the parents of her /r/ kids that all
  liquids have to be drunk through a
  strawbeginning today!
• NO MORE SIPPY CUPS

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Have the client practice

• /k-k-k-k-k/ as fast as possible
• Then, have them prolong the /k/ (/g/ works too)
• We can also use the /ng/--e.g. thinggggrace
• or thingggrock

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II. /r/ WITH SMALL CHILDREN

• As we said in a previous lecture, Hodson (2008)
  believes that we can begin working on /r/ when
  children are as young as 3 or 4
• With these little ones, we dont drill to
  precisionbut we get it on their radar

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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

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For example, when they are reading books with
their children

• They can point out the /r/
• Oh, there is your special tiger sound!
• I ask the parents to model correct /r/
  productions regularly
• BUTdo not push the child too hard to produce it

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III. SPECIFIC TECHNIQUES

• Use visuals of tongue placement
• There are basically 2 ways to produce /r/--in
  retroflexed and bunched position (illustrated on
  p. 92 of the book)
• Retroflexed /r/ is easier to teach, but in the
  long run, I believe bunched /r/ is easier in
  connected speech
• See what works for each individual client
• Mr. Mouth is extremely helpful here most kids
  can show you which position they prefer

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It is best to start each session

• With some auditory bombardment
• It is also beneficial for children to link /r/ to
  print
• I do this even with young children
• I like to use headphones and crank it up 20 dB
  like in the Hodson approach
• We can also do metaphonological awareness
  activities (rhyming, sound blending, etc.)
• I like to even have the children do writing and
  coloring activities

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We need to be sure

• That children are sitting up straight with their
  feet on the floor
• Their bodies need to be stable

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It is very important

• To teach vocalic /r/ before consonantal /r/
• In other words, start with /ar/, /er/, etc.
  before doing words like road, rat, ran
• Save those /r/ blends for later!
• The best thing to do is have children repeat er
  many timesdont jump to consonantal /r/ too
  quickly
• After drilling on er for a few weeks, we can
  jump to C er (ber, mer, ter)
• Avoid words that contain both /r/ and /w/ for as
  long as possible (e.g., rewind, worry)

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• I like shaping /r/ from /i/--eeeeeeeerrrr
• It is helpful to have clients smile, because then
  they cannot make a /w/
• A great technique is from PROMPTthe SLP puts her
  fist under the clients chin and pushes
  upwardthis elevates the tongue
• We can use a tongue depressor to push the
  clients tongue back in her mouth

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The biggest thing with /r/

• Is PRACTICE
• If the client does not practice, there will not
  be progress
• Again, /r/ is hard because strong lingual muscles
  are needed
• Practice makes perfect!