Q: What do you recommend to encourage carryover of articulation skills in an older child with a frontal lisp?
Note: I am writing a book entitled Carryover Techniques in Articulation and Phonological Therapy which will elaborate on this answer in great detail. [EDIT: Book released 2010].
My book Frontal Lisp, Lateral Lisp has a full chapter on carryover techniques for the lisps including:
- Auditory Acceptance – The process a client goes through to accept the way his new sound sounds.
- Determination – Find out what is interfering with the client’s determination to make a change. Address that in therapy.
- Fear – Find a safe person with whom the client feels free to use his new sounds regularly.
- One-Word Assignments – Require the client to say only one word correctly all week long. Select a word of frequent occurrence, like please or thanks.
- Frank Discussions – Talk openly about the client’s error. Frequently ask, “Why do you come here to see me?”
- A Reason to Change – Get away from word lists. Find a reason to change.
- Therapy Intervals – Consider a time off. Many kids integrate what we are talking about over a long period of time. They do not necessarily change in the allotted time.
- Clear Reinforcement – Make sure you are using clear signals of positive and negative reinforcement throughout the course of treatment.
- Parents – Involve parents as you can. Give them simple assignments to do during the course of everyday living. Not homework. Things to do in the car, at the dinner table, etc. Also, assign demonstrations the client can do in front of his parents.
- Rapport – Make sure you have developed rapport. Make sure the client is speaking openly with you about his error.
- Baby Steps – Don’t rush through treatment. Reward him for one tiny step at a time.
- Don’t Be Fooled – Make sure the sounds are correct in terms of oral position. If the client is carefully producing an incorrect sound, and you reward it, it will never carry over.
- Homework – Only assign homework that the client can do with 100% accuracy in the therapy room.
- Speech Binders – Collect papers in a binder that can be reviewed regularly.
- Negative Practice – Practice the error periodically. This jolts the client into the final stages.
- Content – Don’t be too rigid in your approach. Make sure you are not only working on single words. Work in conversation. And make sure to work on clusters. The process of conversation is all about being able to move into and out of phoneme positions in advanced clusters within and across words.