This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
R Therapy in Preschool
By Pam Marshalla
Q: A pediatrician recommended that a 4-year-old child receive speech therapy for R distortion. When do you recommend starting therapy for R?
In my seminars I always say that a preschool child CAN be helped with R, but most therapists don’t feel it is necessary that young.
School-based therapists almost never see these kids that young, but therapists in private practice often do.
Therapists in private practice do so not because they feel it is absolutely necessary but because the parent usually wants therapy to happen RIGHT NOW. Therapy ensues to help the situation. Also, earlier therapy prevents the incorrect motor pattern from firmly fixing in place.
I do see kids for R this young. I tell parents that we do not have to do it right now but that we can if they want to.
If enrolled I teach the child to slide the tip of the tongue back along the palate from L position to Retroflex R position. This is an old Van Riper technique I call the “L-to-R Slide”. Sometimes it only takes one or two sessions to help R emerge in these kiddos.
I can see easily how it can be done, but I have issues with a pediatrician recommending therapy versus recommending they speak to a speech therapist. Maybe I’m being too…I can’t tjink, I’m too tired.
Can you respond to the same issue with the S sound? What age would you start to correct an interdental lisp as a private therapist.
Honestly, SLPs address the frontal lisp in kids as young as 5 and as old as 9. It seems to be that you do what you want when you want. I have seen some for this at 5 because I thought they were ready and could handle it. And I have seen 9-11 years who still weren’t ready. I think it is more about cognition, stimulability, and maturity than it is age.
The older I get and the longer I have been in the profession I have learned to start teaching /r/ earlier and earlier. If I have a kid in therapy for other sound errors and it is appropriate I start to stimulate it! I am stimulating my 3 year old’s /r/ and he can get it. If I am screening kids for errors of concern in the school setting with say a kinder student and that is the only error, so they are not likely to qualify, I try and teach it then and there and check back in to look for progress. Some parents are happy to stimulate at home.