Q: My client backs every lingua-alveolar phoneme. He can do a rudimentary L once in a while, but he substitutes k/t, g/d, and ng/n all the time. What can I do?

You probably are trying to get your client to elevate the tongue-tip to learn T, D, N, and L. This is to assume that the child can be taught to produce these sounds in the adult form. You have to revert back to teaching your client how to produce these sounds the way babies produce them when they first appear. This means that you are teaching the phoneme productions with the most primitive motor pattern instead of the mature motor pattern that is fully formed.

In my observation, the lingua-alveolars emerge in babbling (6-10 months of age), not because the tongue-tip elevates, but because the jaw begins to move up-and-down while the tongue-tip protrudes slightly out the front of the mouth. I call this “jaw babbling.” In other words, babies often babble with D, N, and L by protruding the tongue-tip between the lips and banging the jaw in an up-and-down movement sequence. Try it yourself to feel this movement pattern.

Therefore, when I have a client who cannot produce any lingua-alveolar sounds, I teach the client to stick his tongue out just a little (so that only just the very tip touches the inner surfaces of the anterior lips), and I teach him to move the jaw up-and-down in sequence while babbling. This way the upper surface of the tongue-tip bangs against the upper lip, and the upper central incisors if they are present.

Tapping

Basically you are using the method OTs and PTs call “tapping.” Persistent stimulation in the form of tapping causes increased body part awareness at that part, and it causes muscle tone to increase there (Hagbarth, 1952). Tapping downward on the tongue-tip can cause it to begin to rise.

Practice babbling sequences with D, N, L, and T this way. Also work on simple CV and CVCV words this way (See chart below).

Also, the tongue-tip begins to activate (move more) when babies begin to spit applesauxe and other purees out the mouth by “tongue-spitting.” This is one of the places I almost always use feeding therapy techniques in my articulation work. Feeding therapy methods are an excellent way to stimulate infantile forms of the oral movements that will be needed for speech articulation.

Reference

• Hagbarth, K. E. (1952) Excitatory and inhibitory skin areas for flexor and extensor motor neurons. Acta Physiol Scand 26, p. 1-58.

Words to Practice With Big Up-Down Jaw Movements