TalkTools | Ask a Therapist – Tagged "tongue placement"

Tagged "tongue placement"

Ask A Therapist: /h/ for /k/

Posted by Deborah Grauzam on June 14, 2016

Hi TalkTools,

I have a 6 year old male student who produces /h/ for /k/. He appears to have placement, and is able to produce /g/. However, we have not been successful in nearly a year of therapy with eliciting /k/. His voice is hoarse during conversational speech. His mother is not interested in visiting an Ear, Nose & Throat Doctor. Do you have any suggestions or theories? Thank you.

Angela

Hi Angela,

Based on what you have written he just is not associating tongue elevation with his "k" sound and instead is producing the 'h." I would work on "g" repetitively and throw in a whispered "k" in a sequence of sounds (having him repeat). I would try to get him in the right position over and over and over again and then switch quickly to the "k" and see if that works. Work on teaching "k" as the quiet sound.

Other exercises you can try would be horn blowing, bubble blowing, and straw drinking. This will help to reinforce the back of tongue retraction that is important for that speech sound. Even though it seems he already has the placement with the "g," hopefully the repetition will help get him transitioned to the "k."

I hope these ideas help. Please let me know how it goes and write back with any other questions.

Have a great day.

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.

Ask a Therapist: Tongue Placement

Posted by Deborah Grauzam on March 11, 2013

Hi, I am hoping you can offer a suggestion.

I am an SLP and see a 2 YO child who began sucking on his tongue and had a forward tongue posture before I started seeing him. Once I started working with him I had the family switch to straws only and eliminated the sippy cup. They did that and he continued to have tongue sucking behaviors. Now, he has switched to twisting/turning his tongue around his mouth and it is interfering with his speech sound productions.

I tried to introduce vibration to provide sensory stimulation, but he does not tolerate that in his mouth. I also gave him a chewy tube as a substitution and he will tolerate it, but it is not eliminating the problem.

Do you have any product suggestions? I would greatly appreciate it. He has no drooling, no muscle weakness, and no feeding difficulties. I have never seen a child do this before.

Thank you in advance for any suggestions or product recommendations!

I have a few thoughts on this to help you:

1. Make sure there is not a structural or physiological problem, for example enlarged tonsils and adenoids. If the tongue must be displaced forward for breathing for example it could start these odd habits. Look for a tongue tie.

2. The sensory-motor systems cannot be separated. Though you say there are no feeding issues, I suspect there may be some breakdown in oral-motor development. Look carefully at developmental norms. This will soon be available in the feeding book Lori and I wrote, or you can look into taking Lori's feeding class if you have not already. If this child sucks his tongue at rest, there may be similar patterns on the straw.

3. Use of chewy tubes and sensory motor activities are most useful when you work from the outside of the mouth to the inside of the mouth and the therapy is led by the therapist. So I would not recommend handing the chewy tube to the child, but rather follow Lori's pre-feeding Chewing Hierarchy.

4. Finally, for the tongue sucking, I would recommend tasks that work on tongue retraction. The TalkTools Straw program and TalkTools Horn program, when executed by the directions on the tools kits would be excellent, as would TalkTools Bubble Kit. If you wanted to learn more, we have self-study courses for each of these kits!

Thanks for your interest in TalkTools!

Robyn Merkel-Walsh