Q: My twin clients have been in therapy for a long time and now can produce all the consonants except /r/ and /s/ in clusters. However, vowels sounds are still inconsistent and their speech is choppy and “staccato-like.” Intelligibility is low.

First, kids learn vowels best in isolation, not embedded in the middle of words.

Second, choppy and staccato-like rhythm pattern usually is related to diphthongs that are not fully developed.

Listen carefully to the diphthongs. You can use the following words:

• Hi, bye, tie
• Cow, how, now
• Toy, boy, noisy
• Music, beauty, few
• Bait, wait, baseball

Ask yourself:

• Do the kids really produce each part of the diphthong?
• Do they say the first vowel and the second vowel in each diphthong?
• Or do they say “Ha” for “Hi”, or “Ba” for “Bye” and so forth.

An inability to produce diphthongs means that the client has not learned to glide from one vowel to another. That’s why these children sound pretty good on single words, but very bad in conversation. The inability to stretch through the diphthong usually interferes with the ability to gain other glides. Final /l/ and /r/ are especially effected.

In therapy, these clients need to learn to stretch out (prolong) each individual syllable of words. Start with single-syllable words and progress to multi-syllabic words, phrases and sentences. Model this prolongation of syllable by speaking to them this way throughout the session.

Maaaake yoouurrr wooorrrds streeeetch oouut byyyy exteeeending the vooowwweeels, diiiphthooongs and gliiiides.

It will slow you and the kids down, will make them over-pronounce, and will boost intelligibility nicely.