/s/ elicitation, /l/ elicitation, /r/ elicitation (UNIT 12) NOT FINISHED – Flashcards

*/s/ elicitation*

--The front part of the tongue wide and thin is raised and placed in contact with the upper teeth and gums at the sides and against the teeth-ridge (alveolar) in the front... --This is except for a narrow central opening through which escaping air is directed in a continuous stream... --The teeth are almost closed and the lips are slightly spread... --The escaping breath hits against the edge of the upper incisors producing a hissing sound... --The soft palate is raised and the vocal cords do not vibrate (Nemoy & Davis, 1954).

--Amy Werrett uses a method called the butterfly position. --This method will have Sonia place her tongue in the vowel /I/ position. --She then feels where her tongue is placed. She will notice the sides of her tongue are lifted like butterfly wings, to create a place for the body of a butterfly. --She will then move the air along the body of the butterfly (central groove in the tongue) creating the /s/ sound. --This strategy is recommended to correct a palatal lisp

--Use vocal emphasis to highlight the /s/ sound. --This can be done by prolonging its production (e.g., "Sonia, say [sssssssssʌn]") or by vocalizing it more loudly. --Other verbal prompts would include reminding Sonia about tongue placement (e.g., "Sonia, before you start, think about where your tongue should be.")

--For this elicitation technique you need to use latex gloves. --First, place the thumb and index finger of your left hand at the corners of the child's upper lip. --Second, place the thumb and index finger of your right hand on the corners of the lower lip. --Then, push the lower jaw into the position of a normal bight and pull the lower jaw down to create a very small opening between the teeth. --Finally, ask the child to blow air through their teeth (Secord, Boyce, Donohue, Fox & Shine, 2007).

--Correct tongue placement can be encouraged by asking the child to touch their tongue behind the top incisors on the alveolar ridge. --Correct placement can be additionally encouraged by using a tongue depressor or lollipop to touch the correct place of articulation, and then telling the child to place their tongue on that spot. --As the child has awareness of this tongue placement the child can be directed to release a puff of air, calling it the "snake sound". --If the tongue is being placed outside of the mouth, the child should be prompted to look at themselves in the mirror and to keep their tongue placed behind their teeth. --Prompting the child to smile can assist in keeping the tongue in the mouth during production of the /s/ sound

1. Interdental (frontal) and Dentalized Lisp 2. Lateral Lisp 3. Interdental (frontal) and Lateral Lisp

--One easy method is to ask the child to "Bite, smile and blow." --This can help the child learn to keep their tongue behind their teeth. --A second method is to have the child say the sounds "th-s-th-s-th-s-th-s" in one continuous breath. --This will help increase awareness of the tongue tip and where it should be placed

--One method as taught by Sarah Rose, is to use a straw and a small mirror. --Have Sonia hold the straw next to her closed teeth. Then have her direct the /s/ sound into the straw. --Hold the mirror under the straw. If Sonia directs the air in the correct way, she will be able to see a small cloud form on the mirror. --She will practice the /s/ in isolation and then move on to nonsense syllables. --Next she will move on to words. Decrease the use of the straw as Sonia gets used to directing the /s/ sound to the front of her mouth instead of out the sides of her mouth. --This method will decrease the slushy sound of the lateral lisp.

--The exploding /t/ is a technique that can be used to elicit the /s/ sound for intervention with lateral and frontal lisps if the child is able to produce the /t/ sound correctly. --The child is prompted to produce the /t/ sound repeatedly while the clinician makes the child aware of where the tongue is in the mouth and how it feels. --Next, the child should say the /t/ sound five times, "exploding" the last one so it sounds like "tssss" thus producing the /s/ sound after the /t/. --After the child has successfully produced the exploding /t/ a few times, then the clinician should indicate to the child that they are making the /s/ sound at the end of the exploding /t/. --If the child is able to do this exploding /t/ then the clinician can have the child practice further with words that end in /ts/ such as "rats" or "hats"

*Techniques for /s/ Elicitation and Lisp Therapy*

--A proper /s/ sound occurs when air is channeled down the center of the tongue --Sides and back of tongue are elevated, making contact with inside molars --A groove is created down the midline of the tongue --The tongue tip should either be raised to the alveolar ridge or pointed down toward lower incisors; either position is correct, whichever is more natural *Note: The majority of children can produce the voiceless fricative /s/ sound by 4.5 years

Frontal or lateralized lisp Cluster reduction (kirt/skirt) Cluster substitution (foon/spoon) Stopping (tun/sun) Initial consonant deletion (ock/sock) Final consonant deletion (gra/grass

History of otitis media Orthodontic issues Oral-motor difficulties Hearing impairment Chronic respiratory issues

*Leanna Saenz, M.S., CCC/SLP* Assessment for /s/ phoneme errors: • Goldman Fristoe Test of Articulation • Language sample in spontaneous conversation /s/ elicitation techniques: • Use visuals (hand cues, letter on a sticky note) • Use auditory discrimination with each production the child makes • After they produce the target word, ask them if it was a "thumbs up or down" and why • We talk about the reasoning behind the thumbs up or down Talk about the purpose of coming to speech therapy • Emphasize that it's okay to not be perfect- we have to work on it just like any sport or hobby • Remember- every kid is different! • By the age of 4 years, a child should be producing /s/ in the initial position of words and in the final position of words • Start in isolation, then move up the hierarchy to spontaneous conversation *Kelly McLean, M.S., CCC/SLP* Assessment for /s/ phoneme errors: • Language sample from informal conversation • Goldman Fristoe Test of Articulation /s/ elicitation techniques: • Take what the clients enjoy and try to make games to keep them engaged Ex: With a child who loves basketball, put up a basketball goal in theoffice and if he produced his /s/ sound correctly (by naming pictures on cards that I showed him) for 5 words, he could take 5 shots • Model the /s/ sound • If there is an interdental /s/ tell the child to "keep the snake in the cage, "meaning to keep the tongue (the snake) in the mouth behind the teeth (thecage) • Play a matching game with cards with the /s/ sound in different places in words

• A mental image of a butterfly is used to help the client position the tongue for a correct /s/ production • When you say "i" as in "fit" or "ee" as in "feet", the sides of the tongue are slightly raised, similar to the raised wings of a butterfly • The tongue also has contact with the teeth • A central channel is formed along the middle of the tongue, representing the body of a butterfly • By visualizing the butterfly position, the client learns the correct position to produce /s/, directing the air centrally through the channel versus laterally

Techniques to distinguish error sound: Self-monitoring- client is taught how to distinguish the error sound produced by therapist (and then in their own production) Focused auditory input- client is put into an environment in which he/she can hear the correct /s/ production (spontaneous conversation)

1) Frontal --Individual's tongue protrudes between front teeth --Creates a "th" speech sound for phonemes /s/ and /z/ 2)Lateral --Individual's airstream for the /s/ sound is thrust down laterally around the sides of the tongue" --Results in a slushed noise coming from the sides of the mouth

Also called Interdental lisps --Occurs when a child says the /s/ and /z/ sounds with the tongue pushed too far forward; causes /s/ and /z/ to sound like "th" Soup = thoup Zippers = thippers

*Linda S. Korbakes, M.S., CCC/SLP* --Usually, lisps aren't treated until the client is about 5 years old • Oral strength and control of the jaw is not sufficient until this age --Lisping is typically more common among children with a compromised structure of the oral cavity • Ex: if their tongue and jaw are weak, then they are more likely to lisp --Lisping can also be a cause of phoneme fronting, and in this case, more sounds are often fronted as well • Ex: /n/, /t/, and /ʧ/ --Visual tricks are often effective • "Sammy the snake" • Imitating a whistling teakettle --Long T method is very effective in lisp treatment • Only works if child already has /t/ sound, but must have this sound before treating lisps anyway (and early-developing sound) --Imitation, mirroring, and oral-motor techniques while doing the long T method is effective

--For both frontal and lateral lisps, first focus on correctly producing the /t/ sound --The long T method, which is a process of using /t/ to shape the oral position for /s/, /ts/ or /tʃ/, is extremely effective

1. Become familiar with /t/ • Have client say /t/ several times • Talk about how the tongue tip moved up and down • Make sure the client understands that the sound is caused by air coming out of the front of the mouth from behind their teeth 2. Produce aspirated /t/ • Ask the client to "blow more air through the T" in order to produce a "long T," or a /t/ with strong aspiration (written as tc) • Rehearse tc until it is consistently produced correctly 3. Shape tc into /ts/ • Tell the client to squeeze the air thinner or put the front teeth together and then say tc. Once the client makes the correct sound, drill and positively reinforce 4. Move on to the /ts/ sound (i.e. cats, mats, hats, etc.) • Once the client has this mastered, you can separate /s/ from /t/ 5. Progress to more complex /s/ sounds. • Oral motor exercises that strengthen the tongue are commonly worked on in tandem with the long T method to correct lisps

*/l/ Elicitation*

➔ The /l/ phoneme can be a voiced velar/alveolar glide ➔ Placement of the tongue is essential to produce the sound correctly ➔ Need to use voice to produce the /l/ sound ➔ Two types: dark /l/ and light /l/

Light /l/: (voiced alveolar glide) ➔ Light /l/ sound comes before a vowel or diphthong in a word ➔ Can be referred to as lateral alveolar, which pertains to air flowing on both sides of the tongue ➔ The tip of the tongue will touch the alveolar ridge right behind the top teeth, the lips are relaxed, and the back of tongue lies low. ➔ This sound is usually produced at the beginning of a word (prevocalic)

Dark /l/: (voiced velar glide) ➔ Dark /l/ sound comes after the vowel or diphthong in a word ➔ The tip of the tongue pulls back and slightly touches the alveolar ridge. The back of the tongue rises towards the palate.The lips are rounded slightly before the tongue rises. ➔ The production of this sound comes from the back of the mouth (velar) ➔ This sound is usually found in the middle or end of a word (postvocalic) ➔ Ex. circle, little, milk, fall, puddle, girl

➔ Bilabial: w/l Ex: wike/like ➔ Front-palatal: j/l Ex: jook/look ➔ Central-palatal: r/l Ex: rake/lake ➔ Back-velar/stop: g/l Ex: gove/love ➔ Tip-dental/fricative: ð/l Ex: ðift/lift ➔ Insufficient or excess tongue pressure (voiced lateral fricative) ➔ Blade-alveolar placement

➔ Common Contextual Variants for /l/ ◆ Unrounded /l/: look, leap, let, etc. ◆ Rounded /lw/: loom, loaf, loot, etc. ◆ Voiceless /l̥/: plenty, plus, cluck, etc.

Three Steps for Teaching the /l/ Sound: 1. To teach the /l/ sound place the tongue tip on the alveolar ridge. To help your client do this, touch your client's alveolar ridge with your finger or a lollipop. You can also place some peanut butter or jam on the correct spot. (Just be sure that there are no food allergies!) Then ask your client to place his tongue tip there. 2. Then with his tongue tip in place ask him to relax and then let air flow out the sides of his tongue. 3. Now to make it sound like an /l/ all he must do is make the sound "loud" by turning on his voice.

The Elicitation of /l/ begins with Oral-Motor Exercises ➔ Speech and Language Pathologist (SLP) will have client practice the oral motor exercises involving both articulators: lips and tongue SLP teaches client how to position his/her tongue to elicit the /l/ sound ➔ SLP will hold a mirror, and sits side by side the client. A tongue depressor is then used. The SLP places her fingers in the client's mouth to show the client where to place the tongue. SLP then lifts the tongue up to the alveolar ridge. SLP - Homework/Practice ➔ Client is assigned homework to practice at home. ➔ Client now knows where to put his tongue. Client is instructed to brush his teeth in the circular area so as to reinforce proper tongue placement for the elicitation of /l/

1. Discrimination Approach- listen and discriminate between error and correct production a. Clinician-Client- Client listens to Clinician and discriminates production b. Client-Client- Client listens to themselves and discriminates production 1. Stimulability- teach the correct placement of production a. Tongue depressor b. Mirror c. Straw d. FM system 3. Sound Stabilization- expanding the production in which it occurs a. Isolation c. Words (imitated/spontaneous) d. Phrases (imitated/spontaneous) e. Sentences (imitated/spontaneous) f. Conversation (structured/unstructured) 4. Generalization- generate more natural practice situations to make production natural and automatic

ALWAYS begin with isolation. ➔ Most clients that have a problem with the /l/ subsitute it with a /w/ ➔ The use of tongue depressors and mirrors work well if the client does not understand where the placement of the tongue should go ➔ Once the client gets the /l/ placement down: ◆ Start the /l/ in the initial position of a word because if the client has difficulty with it you can break the word up so it is easier for the client to get the sound down. ◆ REPETITION, REPETITION, REPETITION. The more drill, the best progress made of the client producing the /l/ phoneme consistently. ➔ Fun Activities ◆ Play games as reinforcements. Usually this makes the client say the /l/ sound correctly more often ◆ If the client is old enough have the client grade themselves and compare percentages with them. It gives the client an accurate representation of how often they incorrectly say the /l/ phoneme.

According to the Goldman Fristoe Test of Articulation 2, the /l/ phoneme typically begins emerging around 2.5 years of age and is 90% mastered at 5.5 years of age Boys, specifically, generally master the /l/ phoneme between the ages of 3-6 years old

1. Bilabial: w/l 2. Front-palatal: j/l 3. Central-palatal: r/l 4. Back-velar/stop: g/l 5. Tip-dental/fricative: ð/l 6. Voiced lateral fricative 7. Blade-alveolar placement 8. Omission

Methods of Elicitation: To Eliminate Lip Rounding (w/l) • Description: The clinician makes it difficult for the child to create a rounded lip shape during the production of /l/. • Example: Ask the client to give a big smile. Have the client say syllables like lay, lee, lie or words like lake, lazy, late while wearing that big smile. Initially, avoid syllables such as lou or low that require a rounding of the lips and words such as lime or leaf that require the lips to come together as that's what you're teaching the client not to do! Once he or she can sufficiently produce /l/ with these words, then you can move onto the other /l/ words.

Clinician uses a target sound a child can already produce for the production of /l/, which stimulates the tongue in the correct area for production of sounds

Clinician models the target sound in isolation for the child to imitate --Gives clinician opportunity to see where the child is producing the error --Often the first method used to elicit new sounds --Combines naturally with other elicitation methods (Secord, 2007, p.3 Ex. Clinician engages child for full attention. Then, clinician produces a clear /l/ phoneme and encourages child to imitate sound

Description Clinician demonstrates proper placement of articulators (tongue tip is placed on alveolar ridge) to produce correct sound "Gives the client as many clues as possible to the positioning of the articulators and the handling of the outgoing airstream"

Child will examine what the tongue, lips, and vocal cords are doing in producing the phoneme and have child study kinesthetics of production using mouth pictures, mirrors, and movements

African-American English (AAE): /l/ production characteristics: --Omitted in medial and final positions (e.g. pool becomes /pu/, help becomes /hɛp/) --Replaced occasionally by /ə/ in final position (e.g. pill becomes /plə/) Asian Languages: /l/ production influenced by Asian languages: -- r/l confusion (lime becomes /raim/, hello becomes /hɛrəʊ /) --Because of the variety of languages as well as the numerous dialectal differences in Asian languages, it may be challenging to treat language and phonological disorders