Q: My inattentive three-year-old client suddenly has begun talking on both exhalation and inhalation. Do you have any suggestions to promote proper breathing for speech?

The airflow toys can help teach young children all about the direction of airflow. These include horns, whistles, kazoos, harmonicas, sirens, and spirometers.

• A toy that works upon exhalation only (horn, whistle) can teach a child about moving air outward. Teach him “Blow out.”  (These toys will not sound when inhaled.)
• A toy that works on exhaled voice only (kazoo) can teach a child to exhale when he makes voice. (It will not work if he inhales while voicing.)
• A toy that works on both inhalation and exhalation (siren, harmonica, whistle straw) can teach a child about moving air both ways: Exhale and inhale.
• An inspiration/expiration spirometer also can teach a child about inhaling and exhaling, and about doing so with greater force.
• Also, sound activated toys usually will work only with voice that is exhaled.

We all know that blowing has nothing to do with speech. But we are not using the toys to teach the client to blow. We are teaching him to become more conscious of his own ability to bring air into his lungs, and to push it out. Once the child understands these basic concepts by using the toys, then we teach him to do the same thing while saying sounds or words.

We do not use blow toys and expect a child to fix all his phonemes as if by magic. That is ridiculous, and as you probable can tell by my tone, it makes me very mad that some people assume that this is the reason some of us use blow toys.

We use blow toys, in this case, to teach about airflow. How else can one teach an inattentive three-year-old to inhale and exhale on demand and with control? We use the toys to establish gross control. Then we use phonemes and words to establish refined control.

Use words and gestures to establish these concepts. Establish simple phrases to represent the concepts as he uses the toys, and then transfer this knowledge to the speech targets you have. For example:

Exhalation

“Make the air come out.”
“Push the air out.”
“Blow.”

Inhalation

“Suck the air in.”
“Pull the air in.”
“Bring the air inside your body.”

Exhaled Voice

“Make your voice come out.”
“Make your voice come out so I can hear you.”
“Make your voice come out so I can understand the words.”
“Make the voice come out so you can talk loud enough for grandpa.”

“You can’t make voice while you are pulling the air in.”
“I can’t hear you when the air comes in.”
“Mommy can’t understand you when you suck in your words.”

By the way, if your client can understand and follow these directions without the toys, don’t use them. Just use the directions.