I’ve been a speech-language pathologist in the schools for the past 23 years and for the last 8 years have used the SATPAC Computer program to remediate articulation deficits and phonological processes. Using this program, progress is usually quick but the following 3 cases were exceptionally so.
Coaching Little League Baseball for 3rd and 4th graders, I had two boys on my team who did not have the /r/ sound. After listening to them talk all season, I approached their parents to find out if they were receiving speech therapy. Each told me the same story-that their son had received a year of speech therapy without any noticeable change. One student received group therapy and the other individual.
As a service to them, I offered to see them individually over the summer for 30 minutes once a week. The course of therapy for each student was essentially the same and after 6 sessions, they were both using the /r/ sound correctly in conversational speech. Granted, this was not a typical situation. The parents were highly motivated and followed my homework directions explicitly. Their mothers were present during the sessions and could see how I worked with their sons. Nevertheless, these students were able to remediate a chronic problem quickly and efficiently because of the nature of the SATPAC computer program.
Here is how the therapy proceeded. There was some variation between the students but their progress was similar enough that I can give a general description that can be applied to both of them. Before SATPAC, the prerequisite oral-motor skills were developed. Therapy began with the students learning the proper “EE” position of keeping the tongue back and wide and anchoring the sides to the inside of the back molars. I taught them to differentiate their tongue movement from their jaw movement by having them bite on a Popsicle or craft stick positioned between their back molars on one side of their mouth. They held the stick in front of their mouth, keeping the jaw still and sliding the tongue back and forth on the top teeth. Finally, they were ready to say “EER” keeping the mouth in a tight smile being slightly opened and still while sliding the anchored tongue slightly back. They used a mirror and a flashlight so they could visually monitor their tongue movement. For homework, they practiced the “EER” sound 100 times/twice a day. By the second week, they were ready to put the “EER” sound into a facilitating context with coarticulation for quicker transfer to conversation. The CVCCVC nonsense word they used was “GEERKAP”. This context was facilitating because the /g,k/ sounds keep the tongue back and the /p/ requires no tongue positioning.
By the third week they were able to successfully use “GEERKAP” in the seven different steps of the Establishment Phase. They began using the CVCCVC Generalization Phase lists that have minimal changes between words. This developed a consistent motor memory pattern for the “EER” sound within these nonsense words. They were required to say the words quickly before proceeding to the next list. As competence occurred in each list, the student was moved farther and farther away from the “GEERKAP” facilitating context until they could say the /r/ sound in any phonetic context. It took an additional week to get through all 9 of the Generalization Phase lists.
By week five, they began transferring the /r/ sound into phrases and sentences provided by the SATPAC program. At this point, transfer into spontaneous speech was beginning to occur. Finally at the sixth week, they were able to converse at a slow conversational rate using their /r/ sounds with over 50% accuracy. It was clear to me that with practice, they would continue to improve and in fact they did. I saw them during baseball season the following year and both kids were totally remediated.
The third exceptional case involved a lateral lisp which was remediated in 3 sessions. Because I worked in a year-round setting, I was able to get an extra pay contract during one of my track vacations. I was assigned to a school where the therapist was out on leave. I saw the students on my caseload once a week for what was to be a six-week period. My student was a 4th grade girl who had been in therapy since second grade. She was able to make a reasonable sounding /s/ at the word level but said her words too slow and there was no carryover into conversation. Therapy began as with the /r/ students with oral-motor therapy and the “EE” sound. She quickly progressed to saying “EET” using only the tongue tip for the /t/ sound and keeping the sides of the tongue anchored and stationary. She used a flashlight and monitored her movements visually with a mirror. This moved into saying “EETS” by having her extend the duration of the /t/ sound. She then said “EETS-EE” with a slight pause between the syllables. The reason for the pause at this point was that if she conceptualized saying “SEE”, her lateral lisp would have returned. Continuing, she said the two syllables faster and faster until they were said without a pause in between. Each one of these steps in therapy involved 30-50 repetitions. Her homework for the week was saying “EETSEE” 100 times a day.
I had an IEP meeting with her father later that week and explained the SATPAC program to him. I told him that I would be sending home lists of nonsense words for them to practice together. He was instructed to model the word for his daughter at a normal speech rate and to correct her if she was too slow or if he heard any lateral /s/ sounds.
In the second week of therapy, she quickly moved through the Establishment Phase and into the CVCCVC nonsense word lists in the Generalization Phase. The facilitating context word was “BEETSEEK”. Again, each list consisted of words that had minimal changes from the previous word and each list moved farther and farther away from the facilitating context until she was able to say the /s/ sound correctly in every phonetic context. This occurred during the third week. When I saw her for the following session, she was using the /s/ sound correctly in conversation with near 100% accuracy. I made a point of checking up on her a year later and she still was using the /s/ with 100% accuracy.
Again, she was not a typical case. I had the father present from the start and was able to show him how to implement a successful homework program for her. She was highly motivated to get out of speech and practiced diligently. However, with all three of these students, the systematic nature of the SATPAC program maximized their ability to progress. Developing a consistently correct motor pattern (perfect practice) in the Establishment Phase and the rapid repetitions of CVCCVC nonsense words in SATPAC’s Generalization Phase of therapy led to the successful motor patterns that these students needed to quickly transfer into conversational speech. My success using the SATPAC program has not been as dramatic with my typical student but it has always been significantly faster than my previous articulation/phonological therapy. In this era of high caseloads, little time for preparation and emphasis on literacy, it behooves us to implement articulation/phonological therapy as efficiently as possible and SATPAC is the tool that has allowed me to do this.
For more information contact Stephen Sacks at firstname.lastname@example.org or https://satpac.com/
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