Q: I have an older client who can pass an articulation test but who is very hard to understand in connected speech. I heard you talk about “elocution” in one of your classes. Can you refer me to any written material on how to do this?

A client who can pass an articulation test but who has problems with intelligibility usually is mildly dysarthric. Thus, they have mild problems with prosody (rate, rhythm, stress, intonation, pitch, tone, volume), vowel clarity, and syllable presentation. They generally are speaking too fast for their own capability. They pass the articulation test because they can make themselves be very clear when speaking one word at a time.

Any of my classes on apraxia and dysarthria include a significant amount of information on the topic of elocution. Elocution is the process of teaching clients to speak up, speak out, pronounce carefully, orate, slow down by punching out individual syllables, over-pronounce, listen carefully to monitor one’s own speech, take care in discerning if you are being clear and other’s are understanding you.

This is the way “speech language pathology” was done before the International Phonetic Alphabet came along (1877). So the writings about it are verbose 19th century treatises that are almost impossible to read. The elocutionists of the day wrote in horribly long sentences that frequently ran on for full paragraphs, and sometimes for pages. They apparently did not favor the period; they were verbose to the extreme.

Although old fashioned, elocution should be a part of all our therapies. We should be concerned with our clients’ abilities to speak well first, and to pronounce individual phonemes correctly second.

This means to integrate dialogue about the process of speaking into any of the other work you are doing. Teach the client what good speech is by making general comments about what people “usually do” when they talk. For example, “When people are mad they speak louder.” Or, “When we want to tell others about our situation, we usually slow down and make sure they can understand us.”

Also, make specific comments about how you or the client said something or another. For example:

• “I love the way you were talking about your dog. You told me about him so carefully that I could understand everything you said.”
• “I think I said that tooooooooo fast! I was talking as fast as a racecar. Did you understand me at all?”
• “That was a very, very, very, very, very, very long sentence! You went on, and on, and on! I could not follow a single thing you said! Tell me again. But make short sentences so I can follow you!”
• “Are you talking about a cow or a car? Did you say that your mom bought a new cow? I don’t know why your mom would buy a cow. She lives in an apartment! If you don’t take care while you are speaking, I won’t understand you.”