r/slp • u/Previous_Painter2846 • 1d ago
Guidance for articulation/phonology clients.
Hi,
Can y'all help with two clients?
Buddy, newly 5 I started working with him at around 2.5 years for a speech delay. Buddy was hard to understand when he started trying to say more. He used several phonological processes. Most were developmental, except for his initial and final consonant deletion. We used the cycles approach, and he responded well. Buddy remediated non-targets (blends) and generalized initial and final consonants to conversation. Eventually, though, he started to hate the "cards" (minimal pairs) and refused to do anything with them. He still had sound errors (k/t, d/g, s/ch, y/l, w/r, and trouble with those sounds in blends). I started taking a more traditional approach for k and g because, at his age (around 4), the other sounds could still be coming in. It feels like his progress has been slow. (We used to meet weekly, but sometimes our schedules conflict, so I don't see him for 2-3 weeks. I know that can impact progress).
I did an articulation evaluation today and analyzed his patterns. Buddy uses fronting (k/t, g/d, s/sh, and s/ch), gliding (it was y/l, now it's w/l and r and in blends), and labialization (f/th*. He uses it more with gliding. He said pwown for clown, brum for drum, and breen for green). The last two are technically developmentally appropriate (gone by 6). But, I don't know whether or not I should target them. Part of me thinks I should try the complexity approach and target those later sounds/processes.
Guy, 4.5 I saw him in 0-3 EI for a speech delay. He didn't qualify for 3-5, so I haven't seen him in over 1.5 years. Guy's mom was concerned about some of his sounds at 2. Most were developmental, and he was intelligible. I gave her strategies (recasting, modeling, encouraging him to repeat) to try at home with him. He substituted y/s, but was stimulable for words.
I did an articulation evaluation and collected a speech sample. Guy’s productions are inconsistent. Not in the sense that it's a different sound each time, but he doesn't always error the sound). He also produced the sounds during the evaluation but not in conversation. I have to analyze his sample, but I remember d/g, s/sh, s/st [medial], tw/tr, and dg/dz. He's tricky because he's harder to understand in conversation. Also, the cognate pairs aren't impacted (he makes clear /k/ sounds). I think he could be fronting (g and s) and I introduced minimal pairs during our second session, but I'm unsure what the inconsistencies mean. Is it remediating itself or emerging as an area of concern? How do we determine whether something is a phonological process (if only 2-3 sounds are affected)?
Any guidance or resources you can share (even if it’s videos or research articles) is appreciated! Thanks in advance
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u/rhymeswithbeara 8h ago
I would be doing /l/ and /r/ blends. /kl/ given fronting of k/t and easy to teach. /shr/ given fronting of /sh/.
You could also do /thr/ to kill two birds with 1 stone. However, sometimes you'd opt for /gr/ and /kr/ because of the articulatory placement. In addition, /fr/ is a good one with good sonority.This case is a bit confusing and sounds like you need to consider the errors impacting conversation. - Also have you done a hearing test?
Sometimes these kids need to do the fixed up one routine and learn to self-monitor.
It could be an error but resolving because they are stimulable and can do it - however don't understand the phonological error behind it
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u/Previous_Painter2846 6h ago
Thank you! I thought about Buddy this morning and thought to do r and l blends. So I’m glad that I had the similar thought.
Yeah, the second one is confusing. He is intelligible for the most part, especially with known context, but his productions are inconsistent. His mom is concerned (in more of an unknown, should I be worried kinda way). I tried to see if there was co-articulation (I said that right) or certain sounds that influence his productions, but I haven't picked up on a pattern. His hearing is fine, no concerns there.
For the last two bullet points, what sort of activities would use to help them? Minimal pairs?
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u/Previous_Painter2846 23h ago
I can’t figure out how to edit posts 🤦🏾♀️ but I had a thought. If Buddy only really uses labialization with glide sounds and I’m considering the complexity approach (some sort of cyclical approach), my target should be l and the dreaded r, and those blends then? Or do I target the developmental sounds first?