Q: Do you have any suggestions on how to get a child to place his tongue on “The Spot” (the alveolar ridge)? We tried placing cream cheese as a placement cue but no result.

You are on the right track in using tactile stimulation.  I call this “Marking the Target” of articulation.  But your stimulus is too weak.  Cream cheese is barely perceptible in the mouth because it is too smooth, and it adapts quickly to body temperature.  You want to use a tactile stimulus with more “power.”

The most powerful inter-oral tactile stimuli we can use are these four:  cold, vibration, food, and bumpy textures.  Cold and vibration are too powerful for this specific application.  They should be saved for kids who are barely know they have a mouth, and perhaps are hyposensitive to boot.  Those are cases where we really want to WAKE UP the whole oral mechanism.

Food is a problem here too.  Food stimulates the whole mouth and the nose too, and it sets the salivary glands into action.  You don’t want that much stimulation in this situation.  You want to stimulate just the alveolar ridge, which is a very small place in the mouth.

The best tactile stimulus for teaching a place of articulation is texture applied directly to the target area.  A variety of items could be used including Nuk brushes, toothbrushes, and toothettes.  But the very best tool to use is the child’s own thumb.  The thumb has ridges in the form of the fingerprint, and it is the perfect texture for this.

Have the client reach his thumb inside his mouth as if he were going to suck it.  Have him put the end of the thumb right on the alveolar ridge.  Have him rub forward-and-back there in just that small area.  It also will help him to look in a mirror while doing so.  [Try it yourself on your own palate and notice how the stimulus wakes up the place.]  Have the client also touch the tip of his tongue this way.  In essence, have him touch the two places you want to articulation.

Fun fact–– Did you know that the word “articulate” means “to touch”? Quotable Quote––

“The speech pathologist may touch the part of the child’s tongue that he wants to contact a certain place on the roof of the mouth, then touch that part of the palate or velum to demonstrate the nature of the desired articulation.”
[From: Hanson, M. L. (1983) Articulation. Philadelphia: W. B. Saunders. p148.]