Spring '08 Blog 1

My client, K, is 4 years old. She has been diagnosed with delayed speech and language and she has articulation problems. She has been receiving therapy since Fall ‘07.

K is having problems with /s/, /l/, /t/, and she’s deleting final consonants and reducing initial clusters. She is substituting “him- her” with “he- she”. She also talks very rapidly. For her talking rate I modal slow speech and sometimes I just tell her to slow down without making that very obvious.

The previous clinician worked on some of K’s articulation errors by giving her maximal cues and worked on her pronouns by action cards with many verbal cues. I’m using minimal pairs for her deleting of final consonants, reducing clusters and final /l/ sounds in word level. Using minimal pairs is working pretty well when she concentrates and understands the difference between two different words. I’m trying to keep her on task with different activities and games during minimal pairs since minimal pairs can get really boring for an active 4 year old kid. However, she’s a very bright child who immediately comprehends the difference between right and wrong. So, many times she self-corrects herself. The use of minimal pairs is widely used with children who have many articulation errors. It helps distinguish between target- non-target sounds and it creates more generalization.

Also, I’m focusing on her pronoun confusion a lot, too. I’ve been only using picture cards that show what boys or girls doing. I, firstly, want her to get the idea of correct usage of “he” and “she” in basic concepts before I can move on with carry-over activities. And she is starting to get the idea of the correct use since again she’s self-correcting herself many times! And I’m mostly cueing her about her incorrect productions. Cueing is being used in many areas in speech language pathology. It is very helpful to children if it’s explanatory and if it shows logic. It helps children learn and comprehend the subject. My supervisor also supports these methods and encourages me and the client as she sees the improvement.

K likes almost every activity we do during therapy. She attends well, and works on activities. She prefers visually attractive activities with lots of color and funny pictures.

It’s only been 4 therapy sessions since I’ve been working with K, although both me and my supervisor think, she is improving. She is becoming more aware of what we’re trying to show her and the correct use of speech and language. The methods we’re working on are helping K to develop a more fluent speech and language.

References:
Kouri, Theresa A., Selle, Carrie A., Riley Sarah A. (2006). Comparison of Meaning And Graphophonemic Feedback Strategies for Guided Reading Instruction of Children with Language Delays. American Journal of Speech- Language Pathology, 15, 236-256.

Geirut, Judith A. (2001). Complexity in Phonological Treatment: Clinical Factors. Language, Speech And Hearing Services in Schools, 32, 229- 241.