Questions and Answers

If you have any questions or concerns that relate to speech language pathology in any way, at any level....just ask.
I will answer them to the best of my ability on my blog.
Contact me at

Friday, March 11, 2011

Follow up to /r/ and /s/ Remediation Conference

Ok, so what did I learn.  I learned that /r/ is a really difficult sound to remediate. (as the kids say "duh")  When all was said and done, the therapy techniques Ms. Boshart talked about is what I’ve been doing.  What made her conference difference is that she spoke about tongue stabilization and achieving a good resting position as being key to remediation, which made sense to me.
     How is that done you ask?  She presented some oral motor tasks to strengthen or stabilize the tongue and jaw in the correct resting position.  Some were simple but some were invasive tasks involving entering into a child’s mouth with things like tongue depressors and toothetts.  I understand the science behind it but I was gagging just watching her.  
     One thing she was very unclear on during her lecture (I say lecture because she clearly did not like questions, but maybe that was just to get through the material) was how to diagnosis a distorted /r/.  I found that part very confusing.  However, it didn’t seem to matter what type of /r/ the kid has, remediation was the same.  When asked what to do about students who could say /r/ in the initial position but still produced distortion of r-controlled vowels she glossed over the answer.  In the public schools, r-controlled vowels are very important in reading and phonics.  
     I have to wonder what population Ms. Boshart has worked with in her practice.  Over the years my artic students have usually been been students with average cognition, a little older and appropriate motor skills, except for their mouth.  Most would never feel comfortable with the invasive techniques Ms. Boshart recommends.  When I posed that question, again all she talked about was desensitizing the student little by little.  She either missed the point of my question or again hid the fact that she had no answer.  Eventually she included some outside (the oral structure)  cueing techniques but these were not  emphasized.  
     Now I’m not saying Ms.  Boshart techniques don’t work.  I think she is right about good position being key.  I just don’t feel comfortable going inside a student's mouth.  I believe your typical public school kid will and should feel uncomfortable with some of the techniques presented in this conference.  There has to be another way to achieve this.  Maybe not.  Lucky I live in New England where /r/ is produced in a variety of ways depending on your area, town or neighborhood.  An /r/ that needs to be worked on in the mid-west doesn’t always have to be worked on here. 
     Below is one of Ms. Boshart's links to her products.  Oh yes there was a gift shop at the end of our tour.  Just like at Disneyland. 

Wednesday, March 9, 2011

Remediation of /r/ and /s/

 We are talking the trickiest of the tricky when we talk about working on remediating the 
/s/ and /r/ sounds.  As middle school therapists this is usually all we see in terms of articulation needs and what we dread most.
     With the initiation of RTI in one of the last schools I worked with also came the directive that we wouldn’t see any kids in the middle school for articulation unless they were basically unintelligible.  First I jumped for joy, no more /r/’s or /s/’s.  Well that was fine until I got into their classrooms and heard how some of the kids sounded.  Knowing that I might make a difference in their lives, I felt bad that I wasn’t able to work with them.  
    With a new job and new direction, I find myself in need of brushing up on my articulation skills.  Specifically with those pesky hard to remediate sounds of /s/ and /r/.  I’ve just spent three hours in a conference lead by Char Boshart (we have another 2 1/2 hours to go).  So far I like the information I’m getting.  Really nothing new but broken down into managable order and steps to follow.  You need refreshers every once in awhile. 
     I guess as I am writing this I realize that Ms. Boshart hasn’t gone out and created the “program of the month.”  She has taken what we’ve all be taught in terms of anatomy  and articulation, researched all of it and applied her techniques.  That seems to be the case anyway.
     Her procedure and logic for /s/ sounds appropriate.  On to /r/ this afternoon.  Hope I can pick up some tips.  I have a couple of significant cases.  If Ms. Boshart techniques work and my students improve....... I would look like super therapist.

I'll let you know about how my afternoon works out......