Difficult /r/ Kids

March 17, 2018 12:00 am Published by

I find remediating the /r/ sound to be extremely satisfying because it is typically the last sound learned and the hardest. I have a good grasp of what to do and when to do it and have had lots of success remediating most /r/ sounds in 7 ½ hours of therapy or less.

I use 3 infant tongue depressors taped together which function as bite blocks to stabilize the jaw and then a single infant tongue depressor situated under the tongue for proper placement.

I typically have the student say EE-EE-EERGA or EERSHA as these are facilitating contexts and the EE keeps the tongue wide and flat producing the back or bunched /r/. This achieves palatal constriction with the lateral margins of the tongue contacting the back molars. The ‘A’ sound at the end of EERGA or EERSHA facilitates pharyngeal constriction. Both of these constrictions are necessary for /r/. Typically I can get a good /r/ sound in the first session using these techniques.

However, sometimes my students balk at the whole idea of sticks in their mouths. Right now I’m working with a student who doesn’t like the sticks and doesn’t follow my directions. After about a month of frustration, I decided to work on successive approximations with this student. I started with the stabilization sticks, had him smile and say EE. We did sets of 50 repetitions of EE for a couple of weeks and that was all he needed to do. We then went to EEGA without the /r/ sound which he again could do. Meanwhile, he was getting used to stabilizing his jaw and experiencing success with what I was asking him to do. I then had him put the placement stick under his tongue and had him say EE-EE-EEGA (again without the /r/) and having him push the tongue back on the final EE. And then, I had him do EE-EE-EERGA. At that point I would show him occasionally how the placement stick needed to aggressively push the tongue back. He is still not consistent yet but he can make a good /r/ sound now.
(NOTE: This is just the beginning of my method. If you would like to see more, I have a free CEU presentation on the SATPAC website: https://satpac.com/ ).

Some kids object to the taste of the sticks in their mouths so I’ve used vanilla extract, chocolate or a sour fruit spray to mask the taste and this has worked.

Stephen Sacks

Upcoming workshops: April 12 and April 13 (sold out) in Elk Grove, CA and April 27-28 in So. Cal. Details at https://satpac.com/sacks-workshops/

Because I want SLPs from all over to use and understand my program, I have a .6 CEU ASHA webinar that is basically the same as my live presentations. Go to the SATPAC website for details. Here is the link: https://satpac.com/workshops/webinar

Looking for professional development for your school district or organization? Contact me steve@satpac.com for details.