Q: My client inhales on S. I have tried using a straw and a cotton ball to teach him about airflow. He does fine with these, but he doesn’t transfer the skill to S. Help!

Your client probably continues to inhale on S because he “thinks” he is trying to say S. He has an auditory/motor memory for his own S that he is continuing to access. You have to help him learn to block access to this memory. Here are some ideas:

1. Tell him NOT to make an S, but just to blow through his teeth.
2. Drop back to T and have him practice with inhalation and exhalation, back and forth. Then move on to S. Tell him to make it just like T.
3. Have him make a T into a straw and make the sound “longer” (highly aspirated). I call this a “Long T.” Then work on words with final Ts. Such as hats, cats, lights, and boats. But tell him NOT to make an S, just a “Long T.”
4. Consider making the auditory experience more powerful by switching from a straw to a tube that can reach directly from his mouth to his ear. This may help him to hear the difference between exhalation and inhalation on his S or on his Long T.
5. Use negative practice: Have him practice the inhaled S in order to become more aware of what he is doing wrong.
6. Make sure you are modeling inhaled and exhaled S sounds for him, and have him judge whether you are making each on inhalation or exhalation. This would be the basis of old-fashioned auditory training.
7. Hold a piece of tissue paper against the mouth. The old timers called it a “tissue flag.” Have the client inhale his S so the flag pulls against and hold against his mouth. This will teach him more about how he is inhaling his S. As he is inhaling the S so the tissue presses against his mouth, tell him to blow. The tissue should fly away. Then see if he can transfer the skill to an inhaled and then an exhaled S.
8. Have him inhale the S as he usually does, then hold the oral position while he pants. In other words, have him pant through his inhaled S. This will make it inhaled and exhaled, back and forth. Use the tube for listening harder.
9. Switch to other phonemes for a while. Use any voiceless phoneme. For example, use Sh. Have him inhale and exhale through Sh, back and forth while listening in the tube.
10. Some of the old-timers used saliva to teach exhalation of S. Teach the client to spit a tiny bit of saliva through his teeth, like an S.