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A Hot Tip for Successful "R" Therapy

If you work with children who have a distorted /r/, the following may be the most valuable and critically important strategy you’ll ever use. 


To know where we’re going, let’s take an in-depth look at our destination.  


Let’s think about—and feel—the /r/ placement together.


Close your eyes, and say /r/ out loud; sustain. 



Pay careful attention to the bilateral elevation of the back-sides of your tongue.


Do you feel your back-tongue “corners” touching the area behind your back, top teeth?


It’s the same place you contact for /k/, /g/ and /ng/.



This significant mouth-part behind the top, back teeth is called your “retromolar pads.” 


These pads are the primary points of destination for the sides of the back-tongue.  


This tongue-to-pads contact not only provides the go-to placement for the tongue, but stabilizes the tongue during the entire /r/ production. 


Do keep in mind,


Co-articulated speech requires small oral movements. 


And to generate refined small movements, you must stabilize your tongue near the moving part.


The /r/ requires a solid stabilized bilateral footing. 


The child needs to learn to get there quickly and consistently, during both types of r-contouring (The Back-Up /r/ and The Retroflex /r/), and eventually, across ALL contexts.


So how do you get your r-child to find the tongue-to-pads placement?



Answer: With a Dental Floss Holder (DFH)


This tool is amazing. It’s an SLPs best friend when working with /r/.




(Suggested resource, Amazon.com; the Flossaid Dental Floss Holder)


I suggest that each child has his/her own, and is only used during therapy sessions.


If it goes home, it rarely comes back. 


Place each child’s DFH in a baggy along with a sticky note with his/her name on it. 


Poke a few holes in the baggy for ventilation.



Every therapy session, with the tongs of the DFH, palate the back-tongue corners then the retromolar pads and ask the child to MATCH the two, i.e. elevate the back-tongue and touch the sides to the pads.


At first, palpate for them. 


Eventually, each child will be able to palate his/her own tongue-pad placement.


Say to the child: “A good /r/ is made with the back of the tongue anchored to the pads behind your top, back teeth; like this.” 


Show him/her your back-tongue and retromolar pads. 


Then palpate the child’s. 


The DFH tongs point down when palpating the back-tongue corners, and the DFH tongs point up when palpating the top pads.  



It can be helpful if the child closes his/her eyes to heighten intra-oral tactile perception.


Encourage them to turn their thoughts intra-orally, “Send a spy down to your tongue and focus, place, and feel your tongue-sides on the top pads.” 



Looking in a mirror is fine, but can be distracting for some children.


You may wish to spray some flavored spray on the tongs to increase sensory awareness and enjoyment. (Amazon.com; “Too Tarts Spray Candy”)


If your school district has intra-oral tool regulations, find out what they are and the rationale for them. 


See if they would allow you to get special parent/caregiver approval.  


Oral tools provide oral sensory assists to localize mouth-parts, just as a mirror provides a visual sensory assist. Tools are a helpful part of therapy.



Do keep in mind: Pad placement palpation is not “fancy sound-stim.” It’s not touch the pads and voila, a good /r/.  But it sure is helpful. 


It’s the most important piece in the formation of the /r/.  


In fact, it’s one of three components of the /r/ production (in addition to respiration and phonation): 


1. Placement - on the retromolar pads


2. Lingual Tension – sustained during the production, (/r/ requires the greatest amount of lingual tension of any consonant sound), and


3. A Resonance Chamber – the formation of either a pharyngeal resonance space (for The Back-up /r/), or, an oral space (for The Retroflex /r/)

 


If you want more on /r/, check out Char's courses:


"R" Solutions: From Capability to Carryover


"R" Remediation Therapy


Complete "R" Remediation Therapy


Also be sure to check out CharBoshart.com for Part 2 and 3, and for info and answers on the importance of and how to generate tongue tension and the resonance chamber for /r/.


Have fun!

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