Flashcards in 3.9b Facilitating Techniques Deck (24):
Anterior/posterior Nasal fricatives
- Occlude nostrils if there is a VPI or not easily stimulable
- This eliminates the nasal air loss
- Release /t/ to make /s/:
- This uses a correctly produced stop sound to teach the equivalent fricative
1. Have the child produce a loud /t/ sound
2. Then have the child produce the /t/ with the teeth closed. This will result in /ts/
3. Have the child prolong the production until it becomes /tsss/
4. Have the child note the position of the tongue and the air stream flowing over the tongue during production
5. Finally, eliminate the tongue tip movement for the /t/ component
- This technique can also be used to target: /sh, ch, dg/
- If unable to produce /t/ Extend tongue for /th/ and pull back to form /s/
Anterior/posterior nasal fricatives
- Use auditory feedback (straw):
- This provides the clinician and patient with feedback about oral pressure and oral air flow.
1. Place a straw at the point of your own central incisors during production of a sibilant sound
2. Note the sound of the airflow through the straw
3. Have the child put a straw in front of his incisors and amplify the air through the straw during production. If necessary, have him start with a /t/ sound
4. This can be fashioned into different phonemes: /s, sh, ch, dg)
Anterior/posterior nasal fricatives
- Establish oral airflow for fricative sounds:
- Teach oral airflow through blowing
- Blow bubbles, use cotton balls/packing peanuts (ie: speech puffs)
- May need to use nasal occlusion
As soon as oral airflow established teach consonant production with:
- Bite bottom lip + blow to make /f/ (add voicing for /v/)
- Stick tongue out/between teeth + blow for /th/:
- Pucker lips + blow for /sh/
This helps focus articulation in the mouth rather than the pharynx or velum
Mid-Dorsum Palatal Stops
- For /t/ and /d/
Model an over-exaggerated, labio-dental anterior tongue placement
- Cue child to "put tongue between teeth"
- A mirror can provide helpful feedback
- For /k/ and /g/
Have the child bite on a tongue blade so that it is between the canine or molar teeth
- Make sure it is back far enough to depress the middle part of the tongue, which prevents a dorsal production
Have the child produce velar sounds (/k/, /g/, and /ng/) behind the tongue blade
Can also utilize release of /ng/ for /k/ strategy (say "ink")
Treat when not related to dentition and /or/ for errors persisting following dental correction
Release /t/ to make /s/:
- This uses a stop sound with central airflow to teach central airflow for the sibilant. This requires that airflow for the /t/ is central.
Release /t/ and pucker to create /sh/
How to eliminate very mild hypernasality
- auditory feedback
- tactile feedback
- lower back of tongue
- increase volume (just during therapy)
- Open mouth
- Slow rate of speech
- Eliminate nasal emission
- CPAP therapy
Why do we whisper as a facilitating technique?
eliminates distortion of hypernasality and allows more isolated evaluation of articulation. Eliminates or lessens glottal stop
Why do we occlude nostrils as a facilitating technique?
- Increase oral air pressure by preventing nasal pressure loss
- Prevent nasal air flow associated with "nasal fricatives"
Why do we over enunciate/aspirate (e.g. puff out cheeks) as a facilitating technique?
- Maximizes oral air pressure and velar elevation, which improves intelligibility
- May achieve closure for small VPI
- The amount of velopharyngeal movements is directly related to oral pressure (moon and Kuehn)
Why do we utilize straw placed at central incisors or attached to see-scape for facilitating technique?
- provides auditory biofeedback
Why do we establish oral airflow with blowing as a facilitating technique?
can be fashioned into sibilant sounds
Why do we use tongue blade to restrict anterior tongue elevation as a facilitating technique?
Used in t/k substitutions, prevents tongue-tip elevation, posterior tongue usually elevates spontaneously
Why do we use tongue blade between canines as a facilitating technique?
Open bite when there is an overbite and lateralization of /s/. can help establish placement for mid-dorsum palatal stops
Why do we use reverse chaining as a facilitating technique?
Useful for: blends, e.g. "nake" .... "sssnake"
Syllables: "Na" .... "Li-na" ... "Ca-ro-li-na"
Example: coo?ee --> kee, kee, kee-coo--kee coo---kee
Why do we use a bendable straw?
aka: The variable Directional Air turbulence Detector
- Establish appropriate tongue position-central air flow
Why do we use the see-scape?
Feedback of oral pressure and flow
Why do we use tactile (back of hand)?
Helps maximize oral pressure and articulation
Why do we use oral listening tube/toobaloo?
Amplifies oral sounds
Why do we use air paddle?
- Cut from a piece of paper, it can identify nasal air emission
- Placed in front of the mouth, emphasize oral airflow
What do we need to know about speech viewer/sound recorders?
- Provides different options for displaying and analyzing a signal
- Statistics can be used for assessment and feedback purposes
- Various displays visually differentiate voiced and voiceless cognates
- The displays from a waveform and a spectrogram can be compared
What do we need to know about audacity/voice recorders?
- Great for long distance follow-up
- Can be used to visualize voice onset time
What Ipad apps are good to use?
- Word vault
- Recorder and editor
Why do we use nasometer games?
- provide biofeedback
- ability to set a nasalance threshold
- children speak target utterances while wearing headset
- when threshold is achieved, the image on the screen reacts