Q: I have a preschool student who produces vocalic /r/ with more of a [ng] phoneme. If I address it, what can I do?

There are always several ways to attack a question about articulation therapy. Let me offer two basic ideas to try:

Normal Path of Development

You could teach the client to substitute w/r instead if she can do a /w/ correctly without nasality. Teach her to say “Rabbit” as “Wabbit” and so forth. That puts her development back on the normal path. Older kids do not like this approach because they think you are treating them like a baby, but a preschool child often can have fun with this. This is the very thing I did with one of my own daughters who was struggling with /r/ during the preschool years.

Nasality

You could address the nasality directly by using a flexible tube. Take about a one-foot section of flexible tubing that is one-half to one-inch in diameter. A Rapper Snapper works great for this, or use a piece of vinyl tubing (plumbing or aquarium tubing).

1. Place one end at the child’s mouth and the other at her ear. Have her make a few vowels out her mouth and hear the sound.
2. Then stretch the tube from her nose to her ear. Have her listen to nasal sounds- /m/, /n/.
3. Then have her make her /r/ as she currently does to discover if it is coming out her nose or her mouth.
4. Teach her that /r/ should come out the mouth instead of the nose.

If the client does not have a velopharyngeal insufficiency, and she is basically oral on all other oral sounds, she should be able to get this. She is a preschool child, however, which means it might take her several weeks to get the hang of what you are talking about. Give her time to “play” with the tube, making many different sounds through the nose and mouth. She may need a few weeks of play with it before you can address the phoneme specifically.