A few weeks ago I saw a 10 year old girl for a lateral lisp. We had one session in which we set the sound – that is achieved a good /s/ sound. After that she went away on holiday for a month. When she came back she had completely corrected her lisp. I was amazed and asked her how she went about doing it. She said she practiced the sound like we discussed, and then gradually began monitoring herself, and revising words as she said them, and hey presto, she fixed her own lisp!
While this is a charming story, it is almost the stuff of fairy tales! For the vast majority of children I see for articulation, the transition of using their new sounds in conversation is not easy. This client’s success in using her sound boiled down to one main thing which she had, which many of my other children are lacking – self monitoring skills.
I believe self-monitoring skills are hugely predictive of success in speech therapy, and I try to encourage them from the get go in any way that works for the child. The following are some strategies which I use regularly in therapy to promote generalisation of sounds and self-monitoring.
- Modelling speech sounds in conversation: A simple yet effective strategy of saying the child’s sounds in error back to them correctly with emphasis. This is not to correct the child, but to highlight the correct use of the sound e.g. child “That dod is so cute” adult “oh I know, I love that dogggg, I love that dogggg’s fur”. This is a brilliant strategy for teachers to use at school also!
- Giving specific feedback: “Wow great s sound!”
- Fix it up routine: An effective strategy, but I do always let the parents take charge of how and when they use this strategy. Some kids are perfectly fine with being asked to fix up errors, but for others it can be very annoying! The fixed up one routine can be taught in clinic, and then used at home. When a child makes an error at home, the parent can ask the child to fix it up e.g. “oops, I heard tup, not cup. Can you fix that one up for me?”It is also a good idea (and much more fun) if the parents make some mistakes too. Make sure the mistakes are obvious enough for the child to notice. Then discuss what should be done “Oh no! Silly mummy, I said tup. What do I need to do?”
- Self-rating tasks for school aged kids: Try taking a video of the child talking, and then play it back. Help the child to rate how well they did and which sounds were missed.
- Slowly reduce the structure during practice sessions: Jumping straight from saying a sentence with target words, to expecting the child to talk to you using their sounds is a big jump! This jump can be made smaller by providing some structure to the conversation. Keeping it short, and in a question and answer format can be a good way to go. Make sure you talk to your child about their sound first. E.g. “You are doing so well with your s sound, now we want to practice answering some questions with your sound. Think about what you want to say first, and then say it”
- Speech Quiz! I have made a quiz for all the main sounds I work on with older kids, and always use this as a bridge into conversation. You can up the ante by only giving out quiz points for answers with correct sounds (always making more mistakes yourself than the child during practice!)
- Pacing activities: Some children can talk quite fast in conversation, which makes it more difficult for them to use their sound. Slowing the pace of conversation can help with this. You can use homemade pacing boards (which might just be a row of smiley faces on a strip of paper) where the child has to touch each token when they say each word in the sentence.
- Special vocabulary list: Children often struggle with the words they use most often. Parents can listen to what words with the target sound are used most by their child, and put these into a list. They can then practice them daily so that accurate production becomes the child’s default.
- Sound time: I encourage parents to identify a time when they can talk with their child and concentrate on sounds. You can start with a short amount of time (e.g. 5min) and gradually increase this as the child improves. Discuss how for the next 5min you will be listening out for the target sound. Encourage the child to think hard about using their sound in this time.
- Visual reminders in the environment like a bright note on the fridge, letter sticker on their school books, or a speech bracelet.
- Deliberate misunderstanding: To be used in a playful manner on occasion. Parents can judge whether this strategy is suitable for their child’s personality. Sometimes a child’s error will change the meaning of the word, you could respond to the spoken meaning (rather than the intended meaning) e.g. child “where is my tap (cap)?” adult “your tap? Do you mean the kitchen tap? Here it is, this ttttap?”
- Direct discussions about self-monitoring can be used for some older kids.
Do you use any of these? Do you have any other tips or tricks? Leave a comment below.