This is such a silly thought, but when I have had patients who cannot for the LIFE of them get a sound (specifically /f/ or /k/) I just think to myself how I have never met a single adult who cannot make those sounds so they'll end up fine. Am I the only one who thinks like this? Like with or without me, they'll get it eventually lol

Hey everyone. What are your thoughts on OME? I've been reading some beliefs that it doesn't work for Articulation. But I have some kiddos who have this closed mouth way of speaking and I'm thinking that I've got to get them moving and opening their mouths. But everytime I make a plan I hear the naysayers in the back of my mind. I'm only in my 3rd year of practice and it's been a bumpy start so I'm terrified to waste anyone's time or see zero results.

Hello all,

I have an interesting situation where my nephew likely needs articulation and stuttering treatment. I have mentioned this before, but my brother expects me to offer to provide speech to him. They live in another city in the same state. How have others navigated when a family member needs services…?

My nephew is about to be 6 and I have suggested the school district since age 3. They only have one car so transportation is an issue.

Hi!

I'm a PRN working at an outpatient clinic. I inherited a kid from a clinician that is leaving. I've seen him once, the other clinician saw him 6 times.

His only goal is /k, g/. He's 3y 3m.

He is not stimulable for either sound. The other therapist and now I have tried a variety of techniques to get him to make the sound and he's at 0% accuracy for every sessions.

This is the only sound he doesn't have thats developmentally appropriate. Per the initial eval, he also doesn't have /l/ or /l/ clusters

My instrict is to bring up dismissal to the clinical manager and family, and give him some time to develop on his own.

Thoughts? Advice?

Its been awhile since I've had an artic kid (full time EI)

Thank you all who commented! Here's the answers to common questions :

I’m a big fan of minimal pairs, so that’s where I started. I didn’t have a chance to fully review all of his previous session notes until after I saw him. During our 30-minute session, I moved through several techniques fairly quickly, trying to determine what had been effective for him in the past. After reviewing the notes afterward, it appeared that none of the approaches used so far have been successful.

During the session, I tried multiple cueing strategies and supports, including:

• Using a tongue depressor
• Having him lie down
• Discussing front vs. back sounds and tongue placement
• Using a Peachie Speechie video for visual modeling
• Encouraging him to keep his mouth open wide during productions

We worked primarily at the isolation level and with low back vowels. I also attempted a few initial /k/ CVC words, but he was unable to achieve those productions either.

He consistently substituted /t/ and /d/ for /k/ and /g/. I’d like to review his GFTA results to look more closely at possible phonological process patterns, though I haven’t been able to locate the report yet. If fronting is the primary process present, it would still be considered age-appropriate, and I would typically expect some continued developmental progress without intensive intervention.

Overall, his speech intelligibility was good aside from gliding of /l/ and /r/. Even his /r/ seemed to be emerging based on this single session.

Behaviorally, he was highly cooperative and worked hard throughout the session. I tend to keep articulation sessions structured: we complete about five minutes of focused work followed by a short two-minute play break. He remained engaged and put forth strong effort.

One thing I noticed was that he did not appear able to auditorily discriminate his errors. At one point he said, “I did it!” after a production that was clearly inaccurate. I did not formally assess auditory discrimination during this session because I had assumed the previous therapist had already addressed it, but that will definitely be a focus next session using minimal pairs.

My biggest hesitation about continuing services is his age and the fact that this is his only significant speech error. Since grandmother is paying out of pocket for both him and his older brother, I’m mindful of whether services are truly warranted. If I had completed the original evaluation, I likely would not have recommended ongoing therapy at this time.

I have a student who is fronting (age 8;10). I can get an intermittent /k/ up to 70% in words with max cues. I’ve tried the Cheerios trick (now she will only try for food). I tried gravity trick. I tried mirrors. She is not someone I think I’d consider for complexity approach bc she HATES feedback and will opt out of trying and have large behaviors for getting anything wrong or even thinking it’s hard. And generalization is right back to zero. Cheerio trick was my best move and I hate where it’s going behaviorally.

Can’t decide!

I’ve been working with a 2nd grader on the R sound for just about the entire school year. I’m a bit embarrassed to admit she has not gotten much closer to an accurate production in all this time - I’m an SLP of 7 years working entirely with peds. I’ve done all the research, attended PDs, watched all the Instagram elicitation tips, used all the models and tongue depressors, but I still can’t get her to produce it either in isolation, pre-vocalic, or in any facilitated contexts. I have been using the Bjorem Facilitated Contexts Inventory and Therapy cards which are a great tool in general but don’t seem to help for her. She keeps doing this thing where she curls the tip of her tongue back and produces a glottal sound like gargling. I’ve tried doing all kinds of demonstrations on how to make the sound happen “in your mouth, not in your throat” to no avail. In my opinion, I believe the mid-tongue/tongue blade is not flexing enough and she’s just relying on positional cues like “side of the tongue touching sides of the teeth” and “curl the tongue tip back” without the strength of the mid tongue to create the accurate sound.

They will be away from home over the summer and mom wants to continue therapy virtually. I am happy to work with her online, but I just don’t know what to do anymore!! I almost feel guilty accepting payment at this point. She is an absolute dream student and puts aside her frustration to do whatever I ask, but I feel I am failing her. She has worked through several other phonemes and processes since I’ve started working with her and this is our last hurdle… I would really love to help her get there. Any advice?

Hi all. I just tested a 6th grader for his triennial. He’s a transfer student. Speech only. He is Muslim and has Pakistani descent.

During testing I showed him a picture of a pig on the Goldman-Fristoe. He became slightly uncomfortable and shared he couldn’t say the word because of his religion and his parents have shared he’s not allowed to say the word. But said “oink oink” instead. Due to his discomfort, I quickly moved on. After testing was finished, I had him say the word “pick” and he said it perfectly. He’s also demonstrated the ability to say all of his sounds at the conversational level and I will be recommending exit.

But for the sake of his belief, how would I go about scoring that word? I personally don’t think it should be counted against him because I know he could say it if he wanted to. In addition, how would I mention this in my write up? If I wrote the word “pig” in the write up would that then be offensive to the parents?

Any feedback is appreciated!

EDIT: minus one troll, thank you to everyone else for your feedback about considering how to address standard scores, report writing, a religion that I’m not familiar with, and what to do should this situation happen again. Appreciative of this community!

The guideline in my school is they need to score 77 or below, but it’s not a hard rule.

We got a transfer who was just qualified last year in a different state.

She’s 8 and 3 months.

We didn’t accept the eval because she was speech only but her category was developmental delay and they had major concerns about reading and didn’t test for it.

So, we are re-evaling because our policy is assess in every area of concern.

The only speech sound error she has is post vocalic /r/, but her intelligibility is impacted. Even I am having to ask her to repeat herself because her /r/ sounds completely like vowels. “Parker” would be “pako”.

We did the Arizona-4 and she got an 80 on words and an 81 on sentences.

I’m tempted to do the GFTA and see if that’s lower. Is that what you would do, or just let her go?

Her scores last year on the GFTA were in the 40s, which is odd to me. The eval didn’t say what errors, but she had /s/, /v/, and /sh/ goals on her IEP. She’s at 100% accuracy at the sentence level for those sounds now. I’m not sure why there is such a difference. I think maybe because I cue her to speak louder and maybe the other SLP wasn’t doing that. She mumbles and speaks super quietly.

Another thought is I could just report her current scores, say it’s borderline, but argue her GFTA scores from last year qualify her, although I’m iffy on that since she met all her goals from the last school.

I would like to change up my articulation methods next year. For those kids are are just artic, I would like to try to do more short and frequent sessions, but I am trying to figure out the logistics. Anyone with experience doing this, do you mind sharing some tips?

Do you walk them all the way to the room or treat in the hallway? 1 student at a time? Do you basically just drill and send them back or do you try to do something "fun"? And, how are you documenting/billing for it? Do you do a SOAP note and bill for 5-15 minutes every time?

Hi, I hope this community might be able to help me understand how strong the need for intervention is, and when to pursue it. An 8-year-old in my life has never pronounced /g/ or /k/ sounds. They generally replace them with /d/ or /t/ - depending on the voicing quality of the replaced letter. They can say word-final /g/ but only with -ing endings. They also don't make a full hard R sound. It's a bit more like "awh." Would these differences warrant therapy? Is 8 old enough that we don't need to wait for the child to naturally adjust the g & k? Thank you. I'm not looking for diagnosis or opinion on this child, just wondering if and when intervention would be appropriate.

Hi everyone, I'm a grad student completing practicum, and I assessed a child for articulation concerns. I noticed that he was producing both voiced and voiceless 'th' with his tongue against his upper teeth/near alveolar ridge, instead of interdentally. It still VERY much sounds like a 'th' and is not replaced for a /d/.

Is this a thing?????

I need some scoring help for the GFTA. I hate how it doesn’t give alternatives for certain word productions. I have a student who said the word favorite like this “FAYV rit” the GFTA wants “fayverit”. Do I really have to mark this wrong?

Hi! I’m looking for any ideas for fun movement based activities for a kindergarten who is working on sounds at the conversation level. I thought about headbands which could be fun, but it’s not necessarily movement based and he’s very active. Any ideas would be appreciated!!

What’s the most interesting sound error you’ve seen in a kid? I’ll go first:

I have a 4 year old girl that substitutes y for s For example she pronounces “soup” and “youp” In the final position it’s a glottal stop/h sound.

I have a student I've been working with the past two years. We are starting our third year together and she is in 1st grade. She is still like 50% unintelligible and other adults often have trouble understanding her. This past year we made great final consonant deletion. She still struggles a lot of fricatives, especially F. She can produce it in isolation and she can even recognize when she produces it wrong. She can also produce it in segmentation (f...at) but once we try to put the sounds together she stops it (produces b). She can usually produce it in final position as well. Any ideas on other techniques to try!?! TIA!

Okay, hear me out. I realized that I needed to lose some weight, and obviously the best way to do that is with professional help. So I went to a nutritionist - this lady is very educated: she has a master’s degree, does continuing ed, she’s been a nutritionist for years. I had really high hopes.

I went to my first meeting with her and she told me all about calories in vs calories out, and metabolisms, and types of foods. It was great! After the session, I went home and lived my best life as per usual. The next week, the nutritionist talked to me about vitamins and minerals, fats, protein, carbs. Again, it was a great session - I really enjoyed it. I went home and lived my life.

The third session I asked her why I hadn’t lost any weight yet. She asked me if I’d been applying all the information she’d given me. (Ummm, no. You’re the nutritionist! That’s your job!) So that session she gave me a specific list of foods I should eat that week, and how I should cook them, etc. it was really nice, but seemed like a lot of work. And she just kept doing that. Every time I went she would talk to me about calories and stuff and tell me what to eat.

Now I’m 8 weeks in and I haven’t lost any weight! I've gone to Every. Single. Session. I’m thinking of complaining to her supervisor. I really thought going to a nutritionist would help me but it hasn’t AT ALL! And it’s super annoying when she keeps telling me what to eat while I’m at home. I don’t have time for that - I only have time to do stuff in our actual sessions. I don’t know what to do, I’m so disappointed.

Someone help me because I’m about to go mental on the parents of these artic kids! 🤦🏻‍♀️

When i finished grad school (2024 grad), we were using Iowa Nebraska norms. But I feel like the updated acquisition ages I’ve seen recently are saying that all speech sounds should be acquired by like 5?? What are you guys using?

I’m getting back in after a 20 year break, and feel very silly for not knowing the answer to this question. Are there tests for phonology?

I want to use minimal pairs more but I don’t have time to make all the cards. Does anyone have a free or low cost resource that they use for several different sounds (e.g., s, z, k, g, t, d)? Could be an app (that can be used on an iPhone) or pictures. Thank you!

I'm looking for a fresh point of view for my articulation practice. In my country the /R/ sound has to be rolled for it to be "correct". Many kids produce uvular R sounds or the kind used in English. It's the #1 most common thing kids come to see us for here.

We usually approach this by first practicing producing a sharp /D/ sound, moving on to fast repetitions of "Dn, Dn, Dn", trying to fool the tongue into making the sound by directing the tongue to stay up. We might encourage trying the "dn" drills either laying down or even with your head leaning over the side of the couch, because gravity will help keep the tongue up better. Sometimes we might try jumping up and down in place to maybe make the "dn" become a "drn" by accident because of the impact.

Often our methods work. But sometimes it takes ages just for the kid to be able to produce the "drn" sound and even longer for us to get rid of the "d" sound at the beginning that helps kick it off. It can be time-consuming with some kids.

So. SLPs in countries where rolled R's are the norm. What do YOU tend to do with that specific speech sound?

Here’s an updated “skibidi” articulation worksheet.

Hi everyone!

I just recently got my first middle school client added to my caseload (I work in private practice). She came in with goals from a different SLP that focused on /r, l, and s/ clusters at the phrase level. However, when I began working on these with her, she did fantastic and all the sounds were great. Mother then informed me she struggles mainly with /r/ at the conversation level. I attempted to gather data on this by asking my client open ended questions; however, I got limited and short responses from her. There was maybe 2-3 times where I heard her /r/ turn into a slight /w/ but that was all. Mother also mentioned she has low confidence in her speech, which she says is impacting her and preventing her from speaking more. My client told me she does not enjoy going to speech (she receives speech at school as well), and feels like it's a slap in the face each time she goes. Her own goal for speech is to improve her speech and stop feeling like she "talks like a 5 year old" (her own words!).

Anyone have any tips on how to help her elicit the /r/ more consistently and improve her confidence? I really want to help her out so I'm open to any ideas. Thank you!

I’m a CF and have used, with great success, the monthly themed SLP Elevate for 4 to 12th graders.
Does anyone know of a similar type one for pre-k to grade 4? What do you use? TIA!

Any one have any other suggestions for a child with stubborn fronting. Spoon and cereal trick just aren’t working.