Articulation Therapy

Corie Viscomi
Jun 2 · 3 min read

Does your child say certain sounds incorrectly? He or she may benefit from articulation therapy. Articulation therapy helps children learn to accurately produce age-appropriate speech sounds. This type of therapy follows a structured hierarchy: a child moves onto the next step in the hierarchy after they have demonstrated at least 80% accuracy with their error sound across three consecutive sessions.

Step 1 — Auditory discrimination: Before a child is expected to produce a new sound, we need to make sure that they can hear the difference between their error sound and the desired sound. Auditory discrimination needs to be addressed first, as self-monitoring is key in articulation therapy. However, as most kids can hear the difference between accurate and inaccurate sounds, this step is often omitted.

Step 2 — Isolation: Some kids are stimulable for a certain sound right away, meaning that they can imitate the sound by itself even if they can’t produce it during conversational speech. Other kids need specific instruction regarding how to move their articulations. Either way, kids need to learn how to produce the sound on its own before they can be expected to use it in their speech.

Step 3 — Syllables: After a sound is mastered in isolation it is combined with vowels to form syllables. Vowels should be used before the target sound (is, as, es), after the target sound (si, so, su), and both before and after the target sound (ese, usu, oso).

Step 4 — Words: Like with syllables, it is important to practice the target sound in all positions of words. It should be noted that beginning at the word level, productions are not counted as accurate if they are modeled by the clinician first. In other words, the productions need to be completely independent.

Step 5 — Phrases: Kids who are at the phrase level practice the target sound in short phrases consisting of two or three words. For example, a child working on “r” might say, “My car” or “I want more”. For children who have trouble making the transition between words and phrases, carrier phrases can be used. Carrier phrases are repetitive phrases in which only the target word changes, such as “that’s a ring, that’s a rock, that’s a road”.

Step 6 — Sentences: A target sound in a sentence is practiced in much the same way that it’s practiced in a phrase. It is important to not only vary the position of the sound in the word, but also to change the position of the word in the sentence. This will increase the ease of generalization to conversational speech.

Step 7 — Stories: When practicing a target sound in stories, kids are often given word lists or pictures containing the sound to use. Stories should consist of multiple sentences to provide a transitional step between sentences and conversation. Depending on a child’s age and ability level, reading passages may also be used.

Step 8 — Structured conversation: In a structured conversation, the target sound is assessed during natural back-and-forth conversation between the child and the clinician. Prior to beginning, the clinician will remind the child what sound she will be evaluating. If errors are heard, feedback is given in the moment and the child may be asked to repeat their production accurately.

Step 9 — Unstructured conversation: At this level, kids are not verbally prepped to think about their sound production. The clinician listens for the target sound during casual conversation. If errors are heard, feedback is given at the end of the conversation.

Step 10 — Generalization: The final step of articulation therapy relies heavily on parent report. We need to ensure that the child is able to correctly produce the sound outside of the therapy room and with everyone they talk to. In some cases, this happens simultaneously as the structured and unstructured conversation levels are mastered. In other cases, the clinician needs to provide carryover strategies for the family.

If you’re concerned about your child’s articulation, contact The Speech Studio. A licensed and certified speech-language pathologist can evaluate your child’s sound production and create an individualized treatment plan. For more information check out our website or call (914) 893–2223.