Q: My 12-year-old son cannot say R, however I am not so sure if that is the only problem. Many people do not understand him, a great crisis for him as he starts junior high this fall. He talks very fast. We tried a home program, but I really don’t know what I’m doing. Help!

Your letter points directly to the articulation crisis occurring in this country: Many SLP’s are graduating from universities with absolutely no idea how to fix an R distortion. Let me use this question to discuss four topics: diagnosis, home programming, university requirements, professional development, and equal access to therapy.

First, a thorough diagnosis of expressive speech needs to be made. Many of these long-term R kids are not simply R kids. The distortion of R may be the only error that reveals itself on a test, but these kids often demonstrate additional significant problems in conversational speech. Often they talk too fast, distort vowels, use an incomplete set of vowels, shorten diphthongs, drop syllables, delete final consonants, reduce clusters, and have nasal resonance problems. It is these other factors that reduce intelligibility. Therapy needs to address the R and all the other issues.

Second, the notion that a home program will solve these issues is, in my opinion, ridiculous. The child requires the attention of a professional speech-language pathologist who knows what he or she is doing in regard to expressive speech therapy.

Third, universities need to step up in this regard. Every SLP who graduates from school with a master’s degree in speech-language should have exposure to articulation therapy. They should graduate knowing the basics of working with R, L, and the lisps at the very minimum.

Fourth, SLP’s who do not know how to fix a distorted R effectively need to hook up with at least one therapist who does. Take a half-day and go watch this therapist in action. You will learn more in one hour than you would in any other way. Therapists who do know how to do this work need to offer themselves as mentors to the less experienced therapists.

Finally, it is my professional opinion that children with distorted R phonemes, and other so-called “mild” articulation errors have as much right to treatment as children with severe speech-language impairment. Why we are treating articulation errors as less important is beyond me. These children are our future leaders in education, science, medicine, politics, economics and more. They need clear well-developed speech! If we do not help them with their speech, nobody will.