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: My 10-year-old student with a profound hearing loss and a recent cochlear implant cannot produce any back sounds. We have tried all of the elicitation techniques (tongue depressors, lying on back, gargling) which usually result in her using a glottal plosive instead. Do you have any other suggestions?
I am not sure what you mean by “all of the elicitation techniques.” You mention using a tongue depressor, but you do not say HOW you used it. It’s all about the HOW.
This is what I would do––
- Use a probe (a tongue depressor will work) to press gently downward on the back of the tongue.
- Ask her to push the probe upward with the back of her tongue. She needs to push up high enough to press the probe up against the palate.
- Practice this move until she can do it easily and confidently.
- Then remove the tongue depressor and ask her to do it again.
- Then ask her to do it (without the probe) and to hold the back of her tongue up there.
- As she holds it up there, have her exhale. The resultant sound should be a voiceless velar fricative.
- Have her practice this movement and this sound until she can do it easily and consistently.
- Allow her to use this fricative for K.
- Move on to CV and VC syllables with this velar fricative.
- Bring the probe back in when she falters.
- Move on to words in initial and/or final position still using the velar fricative.
- Allow her to use the velar fricative until she has enough experience to begin to make it better.
- Help her to make it better by pressing up more firmly so it turns into a true plosive.
- If she cannot do the plosive, allow her to continue using the fricative.
- Make the fricative more gently and shorter. The shorter it becomes, and the gentler the movement, the more it should sound like K.
- Stick with K for a while, but eventually add voice back in to make it G.
FYI I had one client who had to produce K as a velar fricative for 18 months before we could shape it into K. So be patient! Do not try to get a perfect /k/ until she is ready. The velar fricative is the pre-speech foundation of the back sounds.