Q: I have a nine-year-old client who inhales as she tries to say R. I have never seen this before. Do you know how to address this?

There is a very simple old-time solution for this using a straw, a few sheets of tissue paper, and a few small cotton balls:

Teach About Exhalation

Place a cotton ball on the table and give the child the straw to hold at her mouth.  Have the child blow through the straw at the little ball so that it blows off the table.  Use this activity to teach her the concept of exhalation.

Teach About Inhalation

Now place a cotton ball on the table and have her suck it to the straw. Make sure the wad is too large to suck in!  The ball should simple be drawn to the straw and stick to the end as the child sucks.  Use this activity to teach her about inhalation.

Exhale a Vowel

Have the child hold a tissue like a curtain in front of her mouth as she says Ah.  Help her notice how the tissue blows gently outward as she says Ah. Use this activity to teach her more about exhalation.  Teach her that all sounds are made upon exhalation.

Inhale a Vowel

Have the child hold a tissue like a curtain in front of the mouth as she inhales an Ah.  Help her notice how the tissue bows gently inward as she inhales Ah. Use this activity to teach her more about inhalation.  Teach her that no sounds are made upon inhalation.

Inhale and Exhale R

Repeat # 3 and #4 above with R.  Teach her that R has to be made upon exhalation, not inhalation.

Contrast Practice

Practice vowels and R back and forth until she figures it out.

Now, before some of you have a seizure because I have used a blowing activity, let me state for the record that I understand that blowing has nothing to do with speech.  We all know this!  We are not teaching blowing as a substitute for teaching R.  We simply are using this activity to teach the child the concept of inhalation and exhalation.  Once the client gets the concept we extend it to the production of vowels and R.

This is an example of a good, old-fashioned phonetic placement method, a method that a modern therapist may call an oral-motor technique.  Old-time therapists employed feathers, tissues, sheets of paper, cotton balls, and mirrors held in front of the mouth.  Here is an example from the very best of the old-time phonetic placement textbooks––

“A visual aid may be found in the use of a feather or strip of paper held before the mouth. By this means the pupil may secure a visual picture of the force and direction of the escaping breath” (Nemoy and Davis, 1937, p. 152).

Reference

• Nemoy, E. M., & Davis, S. F. (1937) The Correction of Defective Consonant Sounds. Magnolia, MA: Expression.