Ask A Therapist: 4 year old with Sensory Processing Disorder

Posted by Deborah Grauzam on

Hi TalkTools,


I am working with a 4 year old boy with Sensory Processing Disorder. When producing the /s/ phoneme he takes a quick inhalation of air. He is able to produce /z/ and /sh/ with appropriate outward flow of air. We have worked on discriminating correct vs. in correct airflow, horn blowing, air hockey with cotton ball or whiffle ball, and cheerio for tongue tip placement with adding the airflow as well. Despite max attempts he is unable to produce the sound in isolation. Any tips or advice you could provide would be greatly appreciated!


Thank you!!!




Hi Randee,

I would work on voice versus voiceless sounds. Having him feel your throat to see that with the "z" you are using your voice box and call "s" your quiet sound and work on the difference that way.  Another thing that I have tried to help with placement is a straw placed on the tongue down the middle out of the front of the mouth.  This helps kids to feel where the air needs to go. But it sounds like he has the placement piece since he is able to say the "z". Just something extra to try. There is also a complete list of oral placement activities to work on "s" and "z" on page 18 in Sara Rosenfeld-Johnson's book: Oral Placement Therapy for Speech Clarity and Feeding. This will give you a list of other activities to try. Let us know if we can do anything else to help.




Elizabeth Smithson, MSP, CCC-SLP is a Speech-Language Pathologist who has over 10 years of professional experience working with infants, children, adolescents and adults. She earned her Master of Speech Pathology at the University of South Carolina. Liz is also a Level 5 TalkTools® Trained Therapist. She has received specialized training in Oral Placement Therapy, Speech, Feeding, Apraxia, Sensory Processing Disorders, and PROMPT©. Liz works with clients with a wide range of disabilities including Cerebral Palsy, Down Syndrome, and Spinal Muscular Atrophy.  She works through her own private practice Elizabeth Smithson Therapy, LLC in the home setting and in the TalkTools® office in Charleston, SC.

airflow Ask a Therapist OPT OPT book OPT to speech oral placement activities oral placement exercises Oral Placement Therapy Oral Placement Therapy book Oral Placement Therapy to speech Oral-Motor s phoneme Sara Rosenfeld-Johnson Sara Rosenfeld-Johnson's book sensory processing sensory processing disorder sh phoneme SPD Speech Therapy TalkTools TalkTools Horn Hierarchy TalkTools Horn Kit TalkTools Horn Program TalkTools Therapy z phoneme

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  • Hi Diane,
    I just emailed you.


    admin on
  • HI! How am I able to leave messages and ideas for other therapists?

    Regards, Diane Reyna

    Level 3 Talk Tools Therapist w/ 30Yrs. + experience in private practice and public schools;
    ages 1-82 !!

    diane reyna on

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