It is difficult for people who don’t know my child to understand what she says. What is your approach for improving articulation problems in children?
Along with traditional speech therapy techniques (targeting individual speech sounds), I use a muscle-based (oral motor) approach to improve the strength and coordination of the jaw, lips and tongue.
When completing a muscle-based assessment, I begin at the level of the jaw, administering child-friendly exercises that a parent or caregiver may carryover for homework. Depending on your daughter’s skill level, exercises for the lips or tongue may also be incorporated. These exercises may include blowing horns and bubbles using specific, hierarchical, adult-directed methods that target the necessary movements for speech clarity.
Exercises to be completed at mealtime may also be incorporated. For example, when a child drinks from an open cup, we want her to use only her lips to take a sip. We don’t want her to use her teeth (jaw) on the cup. It is best to see dissociation—the jaw, lips, and tongue working independently. The same is true for removing pureed food from a spoon. Children should remove the puree with only their lips.
We also want to eliminate the use of pacifiers, bottles, sippy cups, and thumbsucking, as the suckling action that occurs will work against all our efforts. Nutrition should never be compromised; the bottle or sippy cup should be removed when your child can drink effectively from an open cup or straw.
I discuss the recommended exercises with parents during or at the end of each therapeutic session, and a written program plan and detailed instructions are consistently provided. Parents are encouraged to call or email me with questions about the homework in between sessions.
The specific sounds your child has difficulty producing are analyzed using a standardized test. It is then determined which, if any sounds are appropriate to address. This depends on her ability to say the specific sound (maybe she can say the sound in isolation, but not in a word) and the muscle-based results.
I have found that using a muscle-based approach, along with traditional articulation therapy, increases speech clarity in conversation rather than simply at the word level.
If you live in Manhattan and have concerns about your child’s articulation skills, please contact Stephanie at sayandplay@yahoo.com. Stephanie visits children in their Upper East Side Manhattan homes.