Sharing the Love! Unintelligibility Week Daily Tips!
Welcome back to my daily tips to share the love! This past week I was posting tips for treating unintelligible students on IG. Here’s my round-up with a little more information!
Often students who are highly unintelligible have patterns of speech errors going on, so working on one sound at a time is a drop in the bucket!
- Analyze the errors for problems with phonological processes or errors in sound movement patterns based on place or manner.
- Work on these error patterns using multiple sound targets and a variety of words. If the students are making progress, keep it up! If they aren’t, move on to another error pattern and see if it is more stimulable.
- Continue to check back on previous sounds to see if there have been any changes in the students’ stimulability. There are no clearcut guidelines from research for how to proceed with this, although the ASHA website has a good overview. Clinically speaking, I’ve found a few tips to be useful.
- Error patterns that have more visible sounds are often easier to elicit.
- Complete omissions of sounds, unusual phonological patterns and unusual prosody make students very difficult to understand.
- Close substitutions, such as ‘s’ for ‘sh’, impact intelligibility less than a pattern of substitutions that have very little in common with the error sound.
Target List of Words
It is not possible to practice all of the words! Especially with more impaired students who have multiple issues and need more repetition to make improvements, we really need to focus on the most vital and functional skills to have an impact in daily life.
- Have conversations when walking to the therapy room and pay attention to words and phrases the students use the most often.
- These become the target list to practice every session as a warm-up activity.
- When they can say the words correctly, have them practice in the conversational phrases they use.
The rest of the session can include practice with words that tie in to the language activities for the day, but the frequently used word list gets lots of practice!
Watch and Pay Attention
Be sure to watch your students as they attempt new sounds or new words! Some behaviors to notice include:
- Moving their head when attempting to move their tongue
- Smiling all the time (even when not happy)
- Adding additional vowel sounds
These signals indicate that they could be having problems with jaw stability or grading and moving their articulators independently.
Practicing speech production with some extra stability support is sometimes all that a student needs to get better sound production.
I learned so much working jointly with my students’ OTs and PTs. Together, we make a terrific team! If you suspect problems with motor planning or stability issues, these are the people you need to speak to first!
If you are interested in reading more about the development of disassociated jaw, lip and tongue movements for speech production, you can get free access to this article that was published in the Journal of Speech, Language and Hearing Research.
Simple books with repetitive refrains that include your students’ target sounds are a wonderful way to get lots of practice! Most of my students who were unintelligible also had language needs, so this is a great way to target multiple skills.
If your student has to practice many times to gain the skill, be sure to start with some word or phrases that are functional!
- Choose target words to serve a communicative function, like getting a need met, be easy to elicit multiple times by all staff during a typical day.
- Include words that have easy to produce sounds along with the the more difficult ones. Build in some success!
- It’s best of all when the words can be combined to produce functional phrases after the child can say the words!
Simple artic errors? No problem! But when a child is unintelligible and has multiple needs, it can be overwhelming trying to decide the best way to start therapy. I hope these tips help you make your plan!