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!!!

 

Randee

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.

Thanks,

Liz

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.

Hello, I am a Speech Pathologist from the Pittsburgh area.  Could you tell me what you use as far as horns so that I may incorporate them into my therapy sessions.  I see stroke patients who have issues without velopharyngeal closure, and wanted to try your techniques. Thank you so much!

Hi, Your email came at a very good time as I am just finishing my new book on using Oral Placement Therapy with adults. One of the chapters addresses the issue of VPI and how horns can be used in a hierarchy to improve mobility in the velum. The Horn Blowing Hierarchy develops a supported oral airflow and is a pre-requisite for direct work on velar mobility.  The real way to improve closure is by using the exercise called "Oral-Nasal Contrasts." 

I bought the OPT Program, but am struggling with one part of it. I have a child who can hold the bite block #2 between her teeth on the L and R sides for 15 seconds with isometric pull. She can't hold both of the bite blocks between her teeth at the same time with isometric pull (Exercise B) for even one second, though, without demonstrating compensatory strategies (moving head or body forward or pulling up on the chair). I have read and reread the OPT for Speech Clarity and Feeding book looking for what to do next. Page 94 says to make a note of the failure and then proceed to 'Using the Correct Diagnostic Term.' But, in that section, it doesn't tell me what to do. If she fails at having both bite blocks in her mouth with isometric pull, what can I do to strengthen her jaw so that I can then move to bite block #3 for the Bite Block Exercise section?

Without actually seeing the child it is hard to figure out the problem so I will give you some options as any of these can explain the problem:

1. Look at her bite on both sides of her mouth. If she is grinding her teeth or has dental alignment problems that may be the reason she cannot maintain a hold on both bite blocks at the same time. If that is the case then go on to Exercise C - using Bite Block #2.

2. Repeat Exercise A using Bite Block #2. While you are pulling make sure a) you are pulling hard enough, b) she is not tightening her body (even slightly) in any way, as that can also be a compensatory strategy and c) her jaw is not sliding out of alignment (even a little bit). If none of these compensatory behaviors are present, go onto Exercise C - using Bite Block #2.

3. Remember to use the Bite-Tube Hierarchy in conjunction with the Bite Blocks as this activity will also address her jaw instability.

Thanks,

Sara Rosenfeld-Johnson