Vol. 12 Issue 36
An R Therapy Technique that Works
Over the course of my 29 years as a speech-language pathologist in the public school system, I have tried various methods of R therapy techniques. Some were minimally successful; others probably worked due to the child's maturation. None of the techniques used were reliable and consistent for most children's needs.
While driving home from school one day, I began "vocal play" with the R sound to see if I could get the correct resonance that is so often missing, even when the tongue position appears to be in the right place in the mouth. I stumbled upon the use of the short vowel sound "a," as in "at," "cat" and "bat." As I vocalized "a," raised my tongue, and pulled back, I produced the quality of the R sound in the resonance that must occur near the back of the throat. Best of all, when I looked in the mirror to check tongue position, my tongue was up, back and flat instead of pointed and pulled away from the back teeth.
I have used this method to stimulate R in isolation for years now and have developed a hierarchy of the way I teach R therapy to students. I have found that it takes about four sessions to get the student ready to begin initial R words. I have had some students begin R therapy in September and be totally corrected by February. More typically, it takes one to two school years for total correction.
My technique for teaching R follows. Much of what I do incorporates traditional methods with some adjustments and adaptations. Do not make any reference to the R sound during the first four steps of the 10-step process.
In Step 1 I tell my students that we are doing tongue exercises and that they will "feel" and "hear" a new sound as we do these exercises.
Their first worksheet contains the following:
1. Say with your tongue down. Think of the in t, ct, bt.
2. Say with your tongue up and pulled back.
3. Remember to keep your sound as you stretch your sound across these funny roads. (The students move their finger along the "roads" as they vocalize .)
I ask students if they "heard" and "felt" their new sound.
During Step 2, I have the students review the first step and then shorten the new sound to this:
1. Now lift your tongue and pull back using your new sound and make short sounds:
2. Practice a combination of long and stretched sounds and short sounds always using your new .
In Step 3 I have the students begin to blend the new sound with long vowel sounds a, e, i, o and u. I exaggerate my sounds slightly by keeping my mouth open wider, allowing the students to watch my tongue positions as I go through the exercises with them. Lip position should be neutral.
1. Lift your tongue and pull back using your new sound. Keep your voice on the whole time. Say these:
In steps 1-3 I am working on wide-open jaw, tongue position and resonance for R. As we start to blend the new R with long vowel sounds, we lay the framework for words having R sounds in the initial, final and medial positions. These three steps can be taught in individual sessions or in the very first session, depending on the child's ability to understand and use the skills independently. Home practice through all sessions adds to the rate of progress.
When starting Step 4, I tell the students that we are going to blend the new sound with parts of words. I drop the and only use an arrow to indicate that we still want the tongue up and back with the sound we have been practicing. A worksheet looks like this:
After practicing many words with the new R in the initial position and closely monitoring tongue position, resonance and jaw position, we move on to minimal pairs in Step 5. The minimal pairs practice page looks like this:
|| The dog wags his tail at the rag.
||He went west to rest.
||Don't wake up the rake.
||A weed can't read.
Somewhere between steps 4 and 5, the students figure out that we are working on a new R sound. For both of these steps, I give many worksheets for home practice.
In Step 6 we continue to work on the new R sound in the initial position
in words and in minimal pairs. I introduce the sentence level at this
point because I want to get initial R stabilized in functional, meaningful
phrases and sentences. Be careful not to accept any responses made that
indicate the student might be slipping back to his or her old framework
for the R sound. Modifications can be made and lessons reviewed to reinforce
Steps 7 and 8 can be taught in any order, depending on your preference and the abilities of your students. Generally, I teach middle R words next in those words that have R begin a syllable. Examples are "arrow," "parent," "carrot," "parrot," "around," "hurry," etc. As soon as the students have these kinds of words mastered at the word level, we get them into sentences.
Then I teach the new R sound in blends that begin the word. Examples are br-brave, gr-green, pr-pretzel, cr-crow, tr-tree, dr-drum, thr-three and fr-friend. As soon as some of these are mastered at the word level, we begin sentences.
Step 9 uses the blends we just learned and moves to blends in the final positions in words. Examples are br-October, gr-hunger, pr-paper, cr-anchor, tr-after, dr-leader, fr-offer, ser-answer, cher-teacher, jer-danger, ler-taller, sher-washer, mer-summer, ner-winner and ver-over. As soon as some of these are mastered at the word level, we begin sentences.
The final step deals with the ending R, which is the hardest to teach and learn. I teach ending R in word families like ar-tar, car, star, or-door, tore, more and so forth. If ending R is difficult, I have found that linking a final R word with an initial R word strengthens the final R. Examples are car^ride, bear^rock, near^recess, fire^red. Students are told to keep their voice on, keep their tongue up and back, and say the two words like one word.
Another technique is to use connecting words in a phrase or sentence to help pull up the ending R sound. (See the examples in Table 1.) In these exercises the student is told to blend the final R with the next word because we do not articulate every word precisely when we talk naturally. Our words run together, with our ending R becoming a beginning R as we use natural speed and natural speech.
All through the process of R therapy, it is important to refine mouth and jaw opening to ensure a natural production of R. Throughout this method, traditional therapy materials can be used, such as articulation cards, memory games, Go Fish games, and a variety of literature. This allows students to practice their new skills in natural speech activities.
An assessment portfolio helps assess R progress from the word level through the conversation level. (See Table 2.) I have found this portfolio to be very helpful in demonstrating to students and parents which levels have been achieved and which ones need to be remediated. Student self-evaluation should be on-going throughout the therapy sessions.
If this technique becomes just one more tool in your already skillful repertoire, then I am pleased to have shared it with you!
Darlene Pittner is on staff at the Bucks County Intermediate Unit 22. She can be contacted by e-mail at firstname.lastname@example.org.