Q: Do I understand your advice? […] When working on producing the ‘hissing” sounds, my focus should be on the airflow and not the correct sound production. For example, the client can’t say Ch but is able to get a lot of airflow on her attempt when probed. So I should reward her when she says Ts instead. Is this correct?

My experience and research on normal development demonstrates that children learn MANNER before they learn PLACE features.  Thus, stridency “comes in” before the client organizes all the strident sounds by place.

In other words, the DISTINCTIVE FEATURE emerges before children learn to organize all the sounds that have that feature in the correct place.

As such, many children learn to produce a number of strident sounds and they mix them all up for a while before they learn to use the right phoneme in the right place within the right word.  For example, a child might produce “fishie” as “Shishie” or “Thishie” or “Fiffie” before he settles on “Fishie.”  He has added the frication first, and he has organized the fricated sounds by place second.

Whatever occurs in normal development is what I tend to do in therapy.  So when I work with kids who have no strident/fricated sounds I help them first to become aware of the ‘”hissing” element, and I help them produce a variety of these sounds for weeks or months before I worry about whether they are putting the right phonemes in the right words.

As another example, if I am encouraging nasality, I will teach M, N, and Ng all at the same time, and I will let the child mix them up for a while.  He may say “no” as “ngo” for a while as a result, but he is rewarded for using a [+Nasal] sound.  Later he will be rewarded for using the correct nasal sound.

I do this because it reflects normal development and it gives the client more positive feedback earlier in therapy.  Also, some very sever kids –– apraxia and dysarthria and low cognition –– may only be able to do it this way for a long time.  Whereas a typical child may go through this “missed up phase” in a few weeks, our clients sometimes get stuck there for years.

Rewarding the acquisition of the feature and not the phoneme allows the client more elbowroom to learn phonemes and phonological processes.

By the way, this way of doing therapy is one I tested for my Masters Thesis.  Hodson and Paden did not reference it in their little book Targeting Intelligible Speech, and I do not know why.  I think because I had gotten into the whole “oral-motor” thing by then and they wanted to distance themselves from me, but you would have to ask them.  Anyway…  My research demonstrated that this was a valid way of approaching therapy for kids with multiple phoneme errors.  Teach the distinctive feature first.

References

• Hodson, B. W., & Paden, E. P. (1983, 1991) Targeting Intelligible Speech. San Diego: College-Hill.
• Rosenwinkel, P. (1976) Phonologically-based therapy for children with multiple misarticulations. Master’s Thesis. Urbana: University of Illinois. [This is Pam Marshalla’s Thesis under her maiden name.]