Q: My client adds E after all vocalic Rs. Example: She says “deer” as “Deer-ee”. Is this an oral-motor problem? What can I do?

If your client has a correct R in some contexts but not others, then this is no longer about oral motor skill.  She already can attain an R position.  This is a problem of auditory discrimination.

• For some reason, she needs the E after the R to make the R correct in the vocalic position.  Teach her not to use it.
• Spell out exactly what she is doing so she can see it… This will help her hear it.
• For example, spell out the word “deer” as DEER—EEE. (Use orthographic spelling.)
• Tell her, “This is what I hear you saying… Deer-eeeeeee.  You are adding an extra E sound.”
• Use negative practice.  Have her over-practicing her error while pointing to the letters on the page so she can really hear it.
• Slow down the production considerably.  Stretch it out with significant prolongation of sound.
• Have her produce the type of word in synchrony with you. (Both of you do it at the same time.)
• Teach her to STOP production before she gets to the extra E.
• Sometimes I simply have kids put their hand over their mouth when they are about to say the extra sound.  Slowing it all way down allows this action to occur at the right time.