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.
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.