Never Give Up…

There I was, sitting in a speech session in the middle of the week.  It was a monotonous day, one that looked a lot like the few days/weeks/months before it.  But then something happened, and it hit me like a ton of bricks.  Tears began to fill my eyes and I literally had to stop my thoughts in their tracks to keep myself from loosing it right then and there.  An on-looker might be confused about why I was suddenly a teary eyed bawl baby – as it looked like an ordinary day.  But I knew I had just witnessed a MIRACLE.  My client, a five year old severely apraxic little boy had looked up at me in the middle of our session together and with a little bit of a smirk on his face had verbally requested a toy he wanted to play with.  “What’s the big deal?” – you ask.  Well.  I understood him.  Every sound, syllable, and word in the sentence were said correctly.  They were said naturally and easily, as if he wasn’t even thinking about how to get the words to come out.  He SPOKE and I heard his VOICE.  He had a voice, and I had heard it.  I heard his pitch, his tone, his intonation, his resonance.  I heard him.  And it was beautiful.

You see… When I begin working with a severely delayed client I often dream about them.  I dream that I am speaking with them and communicating with them, and they are communicating with me.  In my dreams it is always natural and easy.  They don’t have to work at it.  It just comes out.  When I wake up from one of these dreams I am always hit with such mixed emotions.  Happiness because I heard them speaking, but sadness because I know it was not real.  Hope because I am then driven to make it a reality, and a little bit of fear that it will not be possible.

But on this day, my dream came true.  I heard his voice and it was beautiful.  And it took me by such surprise – because even though I had often dreamed of it – the reality was so much more beautiful than the dream.

On this day, after hours and days and months of practice and drills and models and techniques – it all came together.  He spoke.  Now don’t get me wrong.  He had communicated before, but always with aid and force and fatigue.  But not on that day.  That day it was natural.  That day it was beautiful.  And that day gave me the motivation to push forward because I knew he could do it.

Today, that sweet little boy is like a parrot.  He literally imitates every word, sound, or sentence that comes out of my mouth.  As we climb into our chairs each afternoon to work I always begin by saying “Are you ready to work?” and I always hear his little echo “Are you ready to work?”.  He is amazing.  He used to be scared of his voice.  And tired of trying.  But now he has learned that his voice has power, and with practice and work he can make it do whatever he wants it to.

His mother informed me that last night he said a prayer, and she cried through it because she understood it.  She is getting to meet her child for what seems like the first time.  Because he is unlocking what was always locked inside.

This is the reason I do what I do.  He is the reason.  There is no greater job than helping a child find his voice.  I wouldn’t trade it for anything.

He gives me motivation to continue with each client I work with.  And because of him I am reminded to never give up.

Here is an inspiring message to help you remember to never give up as well…

Speech and Language Warning Signs

The following are speech and language warning signs that will help determine if a child requires speech and language therapy services.  Please be aware that there is a wide range of normal development.  Not all children will have mastered all of the following skills within the following ages listed.  However, if you find that the child’s development is significantly delayed when compared to the skills listed, it may be a good idea to have them evaluated by a certified Speech-Language Pathologist.

By age 2 years the child:

Does not understand any complex sentences

Does not use any 2 word combinations

Cannot identify common objects and pictures when named

Cannot identify up to 5 body parts

Does not refer to self by name

Does not talk about things they are interested in

Does not understand new words daily

Does not use up to 50 words

Does not use any pronouns

By age 3 years the child:

Is not understood by family and/or caregivers

Does not use at least 3-6 word combinations

Cannot repeat when not understood without becoming frustrated

Does not understand what objects do (function of objects)

Cannot correctly produce vowels

Cannot correctly produce the sounds p, b, m, and w in words

Does not understand basic concepts such as little & big, hot & cold

Does not have a vocabulary of close to 1,000 words

Does not attend to activities for up to 10 minutes

Cannot repeat up to at least 3 numbers

By age 4 years the child:

Is not understood by family and/or caregivers

Is not understood by individuals they don’t associate with regularly

Does not have a vocabulary of close to 1,500 words

Cannot express complex ideas in short sentences

Cannot understand basic prepositions such as on, in, under, beside

Does not use past tense verbs correctly

Cannot be asked to repeat without becoming sensitive

Does not understand “why” and “how” questions

Cannot identify basic colors

Cannot correctly produce t, d, k, g, f

Cannot count to 10

By age 5 years the child:

Does not have a working knowledge of the grammatical

principles of their native language

Is not understood in all situations by most listeners

Cannot correctly produce most speech sounds

Cannot carry out more complex commands of 2-3 steps

Does not understand right vs. left

Cannot be asked to repeat without exhibiting frustration

Does not use sentences of at least 5-6 words

Does not use “I” instead of “me”

Setting Your Child Up for Success: Top Five Affective Parenting Techniques

I feel extremely blessed to have been given academic training in a field that gave me techniques that I can use during the administration of therapy as well as in my parenting efforts.  I have compiled the top five affective parenting techniques I have acquired through my experiences as a Speech Language Pathologist.

1. Look for the Positive: 

While completing my graduate work I attended a class in which the professor was teaching us about positive praise.  During the lecture one of my classmates asked the question “What if there is nothing to give praise for – what if the child is not doing anything correct?”  The professor’s answer was swift and clear “There is always something you can give positive praise about, and if you can’t find it – you simply aren’t looking hard enough.”  As a speech language pathologist I think back to the professor’s answer whenever I am working with a “difficult child” – but I really put it to the test during my second year of experience.   I was assigned to deliver services at a specific elementary school that also housed what was referred to as “the behavior unit”.  I provided speech and language services to approximately 75% of the children in the class over the next two years before the class was moved to another school.  The behavior unit is a special class that is made up of all the children from the school district that require a more restrictive environment because they are unsafe to the individuals in their regular education classrooms.  Most of the children in the class were placed there as a result of severe physical harm they had caused to their peers or teachers, or extremely inappropriate behavior they had presented.   At the initiation of services to the students in this classroom, I regret to say that I was apprehensive, nervous, and a little frustrated that I was going to have to learn to deal with these children.  Looking back now – I am grateful for the experiences I had with these children as they taught me more about behavior management and looking for the positive than any other of my therapy experiences.  I learned to love the children and found great joy in the progress they were able to make.  It wasn’t always easy to work with these children – as days could often be filled with threats of violence, abusive language, and extreme persistence to avoid any and all work that was presented.  Sometimes the only thing I could find to praise was the way the child was sitting in their seat or they way they produced a sentence without a curse word.  However, I found that if I focused on the child’s strengths – (even if they were trying at great lengths to hide any strengths they had) it helped make the child feel safe, appreciated, and open to trusting me and developing a relationship with me.  I truly believe that if you look for the positive in anyone – you will find it.  And if you take the time to let them know what you see  – they will be affected positively because of it.

2.  Communicate the Positive:

A great deal of research has been done regarding the power of positive praise.  Research was conducted to see how different outcomes correlated with different ratios of positive to negative feedback in a variety of settings (i.e. marriage, workplace, parenting, teaching, etc.).  The research revealed that the “sweet spot”; or the ratio that resulted with the most successful outcome was 5:1 (5 positive comments to every 1 negative comment).   This is especially difficult while administering speech therapy, as it often revolves around “fixing” clients’ speech and language errors.  If you are not careful you can find yourself providing an overwhelming amount of negative comments (“Don’t do that…” or “Fix that”).  However, the more you make an effort to be aware of providing positive praise – the easier it becomes.  It truly does make a difference in the lives of children, especially in the lives of children who suffer with communication disorders, as they don’t often feel successful.  Make an extra effort to praise them for their efforts (communication wise or otherwise) and I promise you will feel the reward when you see the satisfaction in your child’s face as they realize they have accomplished something great!

3.  Be Specific:

So now that we have discussed looking for the positive, and communicating the positive, – we will delve into even more detail regarding specific positive praise.  All children love to hear “great job”, “way to go”, and “keep up the good work”.  However, that doesn’t really give them any real information about what they did that was great – and what they need to continue to do to be successful.  Your children are learning and growing constantly.  They are experimenting with their boundaries and abilities continuously.  It is up to you to provide them with as much errorless learning as possible.  Errorless learning is extremely important – especially for children who have difficulty learning new things.  It is your job as a parent/teacher/etc. to set them up for the greatest amount of success.  One of the best ways to do this is to provide SPECIFIC positive praise.  For example, when praising your child – exchange a generic form of praise (i.e. “good job”) with “I love the way you…” or “I watched how well you … and it made me really happy”.  The “…” needs to be filled with as much specific information as possible and can be used when helping your child with his/her speech and language, with their behavior, or with any skill you are trying to teach.  I use specific positive praise every day, with my students, my clients, my own children, and even my own husband – and I have found this technique to be very rewarding and useful.  For example I might say to my husband “You are a great dad.  I watched how you patiently taught Brock how to kick the ball, and I saw how much he loved spending that time with you.”  This not only helps my husband feel good about his parenting moment, but it also helps me to clarify and focus on his strengths, which ultimately helps strengthen our relationship and our motivation to be the best parents we can be.  When used with children, specific positive praise produces an empowering teaching moment – in which the child doesn’t really even notice they are being taught, and they come out of it feeling good about their attempts and their success and are inherently motivated to continue working to be successful.

Although being specific is helpful when giving positive praise – it is also very helpful when giving constructive criticism.  In fact, I believe being specific and genuine is what differentiates constructive criticism from destructive (and ineffective) criticism.  This is helpful to keep in mind when your child behaves inappropriately, or when they fail to demonstrate a certain skill correctly.  In order for you to teach them and correct their errors effectively it is highly important to give as much specific information as possible.  Before instituting a consequence for inappropriate behavior you must let your child know exactly what they did that was unacceptable.  Otherwise, they are much more likely to be confused about why they are being punished and repeat the inappropriate behavior.  Then you also need to show them specifically what behavior would have been acceptable.  For example, while working with a child who suffers from asperger’s disorder I learned that I had to be extremely specific in order to teach him appropriate social skills.  If I told him to “be nice” to his classmates I noticed little improvement in his outward behavior.  If I discussed what it means to “be nice”, and I showed him exactly what that looked like – he was able to understand and demonstrate those skills so much easier.  I was amazed at the amount of progress he made quickly once those skills were explicitly taught.  But please be clear that being specific does not always mean being lengthy or necessarily even detailed.  It is most effective to explain yourself as simply and as specifically as possible.  This could consist of imitating the inappropriate behavior followed by a “no-no”.  Imitations and gestures are good for young children or children who have communication difficulties as they might not understand the language you would be inclined to use in your attempt to be specific.  My old supervisor used to observe me giving therapy.  If she ever caught me giving a command (especially to a child that was severely delayed) she would always tell me – show him what that looks like.  For example, I couldn’t ever get away with saying “use soft hands” and leave it at that.  I had to instantly demonstrate what soft hands looked like and then give immediate and specific praise if the child used soft hands.  This again teaches errorless learning.

4.  Be precise:

It is extremely important that children understand and know their boundaries.  Again this is a part of setting up your child for success.  I have found ‘precision commands’ to be the most affective form of boundary setting and consequence follow through.  When using precision commands you are setting up an errorless learning system for your child when it comes to expectations for behavior – on both their part and your part.  Go to the following site to read a full detailed version of how to direct and enforce precision commands. http://www.usu.edu/teachall/text/behavior/LRBIpdfs/Precision.pdf

I love this technique for multiple reasons.  It allows the child to know what is expected of them very clearly.  It sets a very precise pattern which can be learned by all children – even children with severe learning difficulties or very young children.  It helps children feel secure as they know what to expect from you.  It provides a framework in which a child can receive the first command and will be able to accurately foresee the outcome based on their individual choices.  This helps children feel in control and greatly enforces cause and effect and personal responsibility.  Although, the technique is quite simple – there are a few very important things to keep in mind.  DO NOT issue a precision command if you are not willing to follow through with the entire procedure.  If you present the commands but do not follow through on the consequences, all you have done is made empty threats and taught your child that what you say does not really mean anything.  It is also important not to overuse precision commands – they do not need to be used all day long to get your child to comply with your every request.  Precision commands are meant to be used only in more difficult situations.  Also – going back to the first few steps – when the child does comply with your command, please remember to give them SPECIFIC PRAISE for doing so.

5.  Be a Teacher:

As mentioned previously multiple times – errorless learning is one of the most effective things you can provide as a parent and teacher.  There is no exact way to do this (which is funny seeing how I just got finished talking about the importance of precision and specificity).  Just keep in mind that when teaching a new skill, whether it be potty training, acceptable behavior in public, or how to read, your teaching will be the most effective if the process your child undergoes to learn it is as errorless as possible.  This can be accomplished in a number of ways.  I believe that errorless learning can only be taught using a hierarchy of support.  For example when providing articulation therapy I want to avoid allowing the child to produce an error in their speech – which further promotes inaccurate motor planning and processing.  However, not every child can be successful with each speech sound initially and they need to be taught.  This is done through support.  My support might consist of verbal modeling, tactile prompting, visual cueing, or explicit verbal descriptions (to name a few).  Basically I provide the child with whatever amount of support necessary for him/her to be successful.  I then “tip-toe” around the hierarchy – providing more or less support as necessary.  There are always two goals I have when trying to teach a child a new skill.  I ultimately want them to be successful  (meaning producing the sound or target correctly) and independent (meaning producing the sound without any outside modeling, prompting, or cueing).  In order for the child to be successful initially it typically requires a great deal of support.  The next step is to make the child successful independently – which can only occur if the prompting, cueing, and modeling is faded as soon as possible (without sacrificing the child’s accuracy and success).   I think the execution of this process is critical and can be the difference between a mediocre and a great teaching/learning experience.  A great teacher knows how to provide the correct amount of support in order to create success and then fade it as quickly as possible in order to create independence with the skill.  When teaching a new skill keep in mind that in order to be specific, precise, and simple you need to provide explicit directions, clear modeling, and direct cueing, and then fade these cues as soon as possible.  Please realize that there is not a magic recipe for how to teach things successfully – being able to move up and down through a hierarchy of support takes a great amount of focus, flexibility, creativity, and patience.

Tips for Starting Your Own Private Speech Therapy Practice

Fulfilling my dreams at the age of 25: Miss Alissa’s Story

I had many dreams for my life … love, family, laughter, service, beauty, creativity, growth, and purpose.

 At the age of 25 I looked back on my relatively short life and felt fabulously fulfilled.  After finding an incredible husband, graduating with a masters degree in my dream profession, obtaining a job in a devastating economy, building my dream house, giving birth to the most fabulous and beautiful child, I looked around at my blessed life and I had an overwhelming sense of gratitude and peace.  After achieving every goal I had set early on in my life, I found myself being constantly drawn to the more “unachievable” goals that I had lingering in the back of my head.  I had found great purpose in my life by setting goals and working relentlessly until I had achieved them, and my heart couldn’t stop searching for the next goal to attempt.  A Private Practice.  My mind continually wandered to this idea.  However, I constantly shot it down with thoughts of inadequacy and reasons for why I could not accomplish it.  I was too young… no one would take me seriously… I knew nothing about starting a business… I didn’t have the same level of experience as my older colleagues… etc.  I believe the real reason I resisted starting a private practice initially was all due to fear.  Fear of putting myself out there and being rejected.  What if people didn’t like me?  What if no-one felt that I was a good therapist?   How could I take other people’s hard earned money knowing that I was not (and never would be) a perfect therapist?  I was overwhelmingly plagued by the idea that if I started a private practice and it wasn’t successful, it would ultimately mean that I was unsuccessful as an individual.  I was scared to “sell myself”.  I was scared to build something entirely on my name — and my personality – and my character – and MYSELF.

Luckily for me I have been blessed with an unbelievably supportive husband.  He took every negative thought I had and turned it around.  He made me see every reason why I should start a private practice.  He led me through my fears and answered every question I had until I had no other choice then to take that first leap of faith.  And that is how it all began.  That first leap of faith led to lots of late night discussions, scratch paper plans, google searches, and various phone calls and e-mails.

The initial research and planning then led to the following actions…

1.Writing a business plan

See Jena’s super helpful post for guidance @ http://independentclinician.com/how-to-write-a-business-plan-a-guide-for-physical-occupational-and-speech-therapy-providers/.

2.  Obtaining licensing

City License (my city’s business license website http://www.paysonutah.org/development.businesslicensing.html)

State License (my state’s business license website http://www.dopl.utah.gov/licensing/speech_audiology.html)

3.  Building a website

Check mine out at www.utahspeechtherapy.com

4.  Designing business cards

Front

Back 

5.  Creating brochures

Check mine out at http://www.utahscommunicationconnection.com/downloads/brochure.pdf

 

I then needed to prepare my location.  My plan was to conduct therapy out of two bedrooms in my home (a therapy room and an observation room).  I set up the rooms by purchasing discounted/used furniture and sprucing them up.  I bought a laptop computer and some standardized tests to get started.  I organized and set up all the therapy materials I had gathered over the last few years.  Financially I invested in total a little over $2000 to get my business started.

Therapy Room

 

Observation Room

(where parents view therapy being conducted in the room next door via a camcorder hooked up to a television)

             My next step was marketing (a website does nothing for you if no-one knows it exists).  I contacted the local early intervention agency and asked if I could give a small presentation.  I spoke to therapists that worked for the local school district.  I took some business cards to my baby’s check-up appointment and presented my business ideas to the pediatrician.  I sent letters and brochures to other pediatricians in the area.  And then I waited…

 Referrals came.  People were interested.   It was exciting and exhilarating.   As the months progressed, my remaining fears of being inadequate slowly began to fade.  I realized that I did not have to “sell myself” as much as I thought I would need to.  I realized that I did not need to be the “perfect” therapist.  By the time most people contacted me they were very serious about helping their children and were already invested in the process.  All I had to do was make sure that I was providing appropriate therapy that was planned out and effective.

 We (as SLPs) are so fortunate to work in a field that has a great deal of demand.  People search us out – we just have to make ourselves known.  We get to change their lives.  What an incredible blessing.  As far as my life goes now – I feel like I am truly living the dream.  I spend most days at home with my little one – and provide therapy privately on the side.

  I get to work out of my home which has great advantages (such as throwing a load of laundry in the washer in-between clients, eating lunch at home, having all my therapy supplies and materials at my fingertips, getting some of my mortgage written off by conducting therapy in my home, etc.).   When I finally committed to beginning my private practice I did so because I realized there were far too many advantages that outweighed the fears I had – and I had to face the risks and take the first leap of faith.  My reasoning behind sharing my experience is simply for me to be to you all… what my husband was to me… a support system, a cheerleader, a confidant, a sounding board, and a friend.  It was my dream and I did it.  If it is your dream you can do it too!!!

Top Ten Techniques to Teach /s/

 The TOP TEN techniques to teach /s/

 1.  DETERMINE THE PROBLEM…

The most common problems producing /s/ correctly are as follows:

a. Inability to produce the /s/ at all. (See tips 2 and 3)

b. Can say the /s/ all by itself, but omits it from words or conversation. (See tips 4 and 5)

c. Uses the /s/ in conversation but produces it with a frontal distortion (See tips 6 and 7)

d. Uses the /s/ in conversation but produces it with a lateral distortion  (See tips 8 and 9)

Go to this link to read more about frontal and lateral distortions http://www.superduperinc.com/handouts/pdf/209_Lisp.pdf

 2.  THINK /T/…

No /s/???  No worries!!!

If your child is not able to produce /s/ at all  – the first place I like to start is with a /t/.

Did you know that /t/ and /s/ are produced in the same place in your mouth?

They are both produced by touching the tip of your tongue to the bumpy spot directly behind your top front teeth (the alveolar ridge).  However, a /t/ is produced by building up your air pressure and popping it out in one short burst, and an /s/ is produced by pushing air out continually.

So… I like to think of /s/ as a long form of /t/.

In order to get your child to be able to produce /s/ correctly, try my “T-to-S” therapy technique.

3.  IT’S ON THE TIP OF MY TONGUE

 If your child is not able to produce /s/ at all – another good idea is to give some simple directions.

All consonants have what speech therapists like to call a PLACE and a MANNER.

The PLACE of a sound refers to the specific point your articulators make contact in order to produce that sound.  The MANNER of a sound refers to how the articulators are involved in producing that sound.  When speaking about /s/, it’s place is the alveolar ridge (or the bumpy spot behind your front top teeth), and its manner is a fricative (or a sound produced by pushing air through a narrow opening – i.e. /f/,  /th/).  This information is helpful when trying to direct a child to produce /s/ correctly.

I often tell the child to put the tip of their tongue on the bumpy spot behind their front top teeth.  If they are having a hard time finding the correct spot I usually gently rub the spot with a tongue depressor so that they can feel it.  After they place the tip of their tongue on the bumpy spot, I have them bite their teeth closed, smile, and blow their air out.  This often results in a beautiful /s/ sound.

4.  WHAT’S IN A NAME?

 If your child can say the /s/ all by itself (in isolation) but omits it from words or conversation, the best thing you can do is give the sound a name. Often times kids that struggle with speech sounds are too young to read, so referring to the sound your mouth produces by the letter you spell it with can be confusing.  Also – in the English language certain sounds can be spelled with more than one letter.  /S/ is a great example of this.  The words “circus” and “some” are spelled with different letters at the beginning (c/s), but they both start with the same sound (produced by the mouth – /s/).  This is obvious to you and I (adults) but is somewhat confusing to children who may not be proficient readers yet.  It is much easier to refer to a sound by a name rather than a letter, as you can teach more consistently that way.  Some possible name options for the /s/ sound are: “The Hissy Sound” or “The Snake Sound”.  You can also come up with a name of your own.  It is important to find a name that goes along with the sound or reminds the child of the sound.  It is also important to be consistent and use the same name for the sound continually.   After you have given the sound a name, you can use the name to remind your child when to use the sound.

5.  LET’S GIVE EM A HAND

 If your child can say the /s/ all by itself (in isolation) but omits it from words or conversation, the best thing you can do is give the sound a hand signal.  A hand signal is a great way to reinforce a sound, or draw attention to it.  You can emphasize a sound in a word by pairing a hand signal when the sound is said.  If your child says a word that has an /s/ – but he/she omits the /s/, you can give them a simple reminder by showing them the hand signal that is paired with /s/.  This is a way to give them a reminder without having to verbally direct them to fix their mistake.  It is less intrusive and less overtly critical.  One of the things I tell parents to do with their children for speech homework is to read one book a night and use the hand signal each time they produce an /s/.  This shows the child which words contain an /s/.  It helps emphasize the /s/’s in the story and draws extra attention to them.  Both of these things are important for kids who are omitting the /s/ from words.  The hand signal I use for /s/ starts by placing my right pointer finger on the back of my left hand.  I then move my right hand in a squiggly line up my left arm (stopping at my elbow).  I say a long /s/ sound while doing the movement.

6.  CHECK FOR TONGUE THRUST

 If your child can say the /s/ in conversation, but produces it with a frontal distortion, the first thing you should do is check for a tongue thrust.  A tongue thrust is actually an abnormal swallow.  Did you know that Speech Language Pathologists are not only speech experts, but swallowing experts as well?  An abnormal swallow can greatly affect a child’s ability to produce sounds correctly as it can interfere with the proper development of the oral musculature.  All individuals swallow with a tongue thrust during infancy, but eventually develop a mature swallow pattern over time (which also helps their speech develop correctly over time).  If the tongue thrust does not develop into a mature swallow, speech development can be negatively affected.  I have worked with many individuals who swallow with a tongue thrust and these individuals often have co-occurring speech issues as well.  It is often the case that I treat an individual’s tongue thrust and their speech issues improve concurrently (with NO actual speech therapy given).  Tongue thrust therapy is actually very fast (it can usually be completed within 9-10 sessions) and is EXTREMELY effective.  Click here to find out more about the causes, signs, symptoms, and treatments of tongue thrust.

 7.  KEEP THE SNAKE IN IT’S CAGE

 If your child can say the /s/ in words or conversation but produces it with a frontal distortion, try teaching your child an analogy.  I like to use an analogy about keeping the snake in its cage (and no – its definitely NOT what you are thinking-haha).  I like to tell my clients to pretend their tongue is like a snake and their teeth are like the snake’s cage.  When they produce an /s/ they need to keep their tongue behind their teeth (or their snake inside its cage).  I usually give them a mirror and let them self check whether or not they are doing it right.  They should keep their teeth closed tight and should not be able to see their tongue at all while producing the /s/.

8.  THINK /T/ (AGAIN???)

 If your child can say the /s/ in words or conversation but produces it with a lateral distortion, try using /t/ (again???).  Yes Again.  /T/ can not only help your child produce an /s/ in the first place, but it can also perfect an /s/ with a lateral distortion.  As mentioned in tip #2, /t/ and /s/ are produced in the same place in your mouth.  And they both push air out of the center of the mouth, only /t/ does it with a short burst of air, and /s/ does it with a longer stream of air.  Most of the time when a child has a lateralized /s/ (meaning they are pushing the air out of the sides of their mouth rather than the center), their /t/ airflow is correct.  So, you can use the correct airflow from the /t/ to build up to an /s/ that is perfect.  You can do this by using my “T-to-S” therapy technique.  It is pretty much the same technique as listed in tip #2, however I would like to stress a few parts of the technique.  The most important thing when using this technique with a lateralized /s/ is to NOT let the child know you are working on their /s/.  If the child knows they are trying to work on the /s/ they will fall into their old lateralized airflow patterns and it is very hard to fix.  Instead, only refer to the /s/ you are building as the “Long Ticking Sound”.  And do not let the child know they have been producing an /s/ all along – until they have produced many hundreds of repetitions of the “Long Ticking Sound” correctly.  Only then can  you let the child know that the “Long Ticking Sound” is actually the /s/ sound and you can then begin working on the sound in words and conversation.

 9.  USE A STRAW

 If your child can say the /s/ in words or conversation but produces it with a lateral distortion, try using a straw.  It is hard for children to understand where they are directing their air.  I like to use a straw so that my clients can actually hear where their airflow is being directed.  Unlike the picture above – I don’t actually put the straw in the child’s mouth.  I hold the straw completely vertical and rest it just against the child’s bottom lip.  I then have the child produce a long /s/ sound.  As the child produces the sound I gently move the straw across the child’s bottom lip.  When the straw crosses any airflow it amplifies the sound the air is making.  For a child with a lateralized /s/, the sound will be amplified when the straw is on either side of the mouth.  For a normal /s/ the sound will be amplified when the straw is placed in the center of the mouth.  You can help the child hear the difference between your airflow and their airflow and can direct the child to try to make the airflow come out in the center.

 10.  CONTACT A CERTIFIED SPEECH LANGUAGE PATHOLOGIST

 If all else fails.  Contact a certified Speech Language Pathologist.

I have shared with you some fool proof techniques to help your child produce /s/ and use it appropriately in words and conversational speech.  However, at the end of the day it is nearly impossible for me to share with you all that I have learned throughout my education as well as my professional work experience.  If your child is still continuing to struggle with his/her speech, please contact me for further questions, or contact a certified speech language pathologist in your area today.  I promise it will be worth it!!!