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 to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Q: I cannot get K or G out of my client although I think I have tried every trick in the book! For example, I have used modeling, auditory bombardment, tactile cueing, using a tongue depressor to hold the tongue-tip down, using a tongue depressor to push the back of the tongue down to create the reflex to get it to pop up, putting sweet taste on the velum to get back of tongue to reach for it, using gravity, having him look up while saying “k”, and making the “crashing” sound while playing with cars. I cannot get him to keep that tongue tip down.
Everything you are doing sounds great, but I think you might be doing one method wrong. You wrote that you were “using a tongue depressor to push the back of the tongue down to create the reflex to get it to pop up.” Let me straighten this out. You may be doing it right and just writing it wrong, I’m not sure. It’s hard to put some of this stuff into words…
Basically we don’t “push the back of the tongue down to create a reflex to get it to pop up.” I think you are combining the Tongue Retraction Reflex with the idea of using Resistance to teach tongue-back elevation.
1. We can stimulate the TONGUE RETRACTION REFLEX to get the tongue to retract back and hump up.
To do this we stimulate the upper surface of the tongue, from tip-to-back down the midline. As some point, usually about 1/2-way back to 2/3-way back, the tongue will retract, meaning that the whole tongue will retreat backwards and hump up to form itself into a ball that occludes the oropharyngeal area. The balled-up tongue forms rather a “plug” for the oropharynx. We continue to tease the tongue (tap it) so that it stays up there momentarily. While it’s up there, ask the client to say H gently. If it works, it will cause him to say H while the whole tongue is balled up toward and pressing gently up against the velum. This will sound like a VELAR FRICATIVE or VELAR RASPBERRY. Now you have the “crashing sound” that can be shaped into K.
2. We can use RESISTANCE to stimulate upward movement of the back of the tongue.
To do this we press DOWN gently on the back 1/3 of the tongue with a tongue depressor while asking the client to “Push it up.” This literally teaches him to push upward with the back of the tongue. If he can’t do it, use something with more power––like a cold metal spoon, or a Nuk with its nubs. To make this even more powerful, and actually simpler, have him do this to himself with a tongue depressor, or have him use his own finger so he can feel the upward movement of the tongue-back.